<TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR>Best not to treat 1 in 3 breast cancers: Study
</TR><!-- headline one : end --><TR>Tumour in these cases so slow growing they are not life-threatening </TR><!-- show image if available --></TBODY></TABLE>
<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->PARIS: Women take note: Not all breast cancers kill.
One in three women diagnosed with breast cancer in public screening programmes are being treated needlessly, a new study has found.
The reason is that their tumour will not be life-threatening, the British Medical Journal (BMJ) reported yesterday.
The study by Scandinavian experts highlighted the dilemma facing doctors when it comes to detecting and treating breast cancer - the 'silent killer' of women, thus named for the way it can stealthily claim lives.
But not all breast cancers are life-threatening. In some cases, the cancer will grow so slowly that the patient will die of other causes before it produces symptoms, or it may remain dormant over the years or even shrink.
Because doctors have no idea whether the cancer will be lethal or harmless, they tend to treat all patients diagnosed with a tumour. But cancer treatment, using powerful drugs, radiotherapy or surgery, causes harm.
So it is vital to know how many patients may be getting unnecessary treatment, especially given the huge investment in having women undergo regular mammograms.
Dr Karsten Jorgensen and Dr Peter Gotzsche of the Nordic Cochrane Centre in Copenhagen pored over data from screening programmes done in Australia, Britain, Canada, Norway and Sweden.
They looked at trends seven years before the programmes were implemented, and seven years after.
Once screening programmes began, more cases of breast cancer were inevitably picked up, the study showed. If a screening programme is working, there should also be a drop in the number of advanced cancer cases detected in older women, since their cancers should theoretically have been caught earlier when they were screened.
However, the two experts found the national breast cancer screening systems, which usually test women aged between 50 and 69, simply reported thousands more cases than previously identified.
Overall, Dr Jorgensen and Dr Gotzsche found that one-third of the women identified as having breast cancer did not actually need to be treated.
Dr Jorgensen said that for years, women were urged to undergo breast cancer screening without them being informed of the risks involved, such as having to endure unnecessary treatment if a cancer was identified, even if it might never threaten their health.
'This information needs to get to women so they can make an informed choice,' he said. 'There is a significant harm in making women cancer patients without good reason.'
Doctors and patients have long debated the merits of prostate cancer screening out of similar concerns that it overdiagnoses patients. A study in the Netherlands found that as many as two out of every five men whose prostate cancer was caught through a screening test had tumours too slow growing to ever be a threat.
In an editorial also published by the BMJ, Professor Gilbert Welch, at the Dartmouth Institute for Health Policy and Clinical Research in Vermont, said the new findings raised the key question about the trade-off between deaths avoided and harm inflicted by screening programmes.
One study has suggested that one death is avoided for every two women who are 'overdiagnosed', while another puts the ratio far higher, at one death avoided for every 10 cases of unnecessary treatment.
Prof Welch called on the medical profession to draw up a simple statistical table to help women weigh the risks and the benefits from breast cancer treatment.
'Mammography undoubtedly helps some women but hurts others,' said Prof Welch.
'No right answer exists, instead it is a personal choice.'
AGENCE FRANCE-PRESSE, ASSOCIATED PRESS
<HR SIZE=1 width="50%">
One study has suggested that one death is avoided for every two women who are 'overdiagnosed', while another puts the ratio far higher, at one death avoided for every 10 cases of unnecessary treatment.
</TR><!-- headline one : end --><TR>Tumour in these cases so slow growing they are not life-threatening </TR><!-- show image if available --></TBODY></TABLE>
<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->PARIS: Women take note: Not all breast cancers kill.
One in three women diagnosed with breast cancer in public screening programmes are being treated needlessly, a new study has found.
The reason is that their tumour will not be life-threatening, the British Medical Journal (BMJ) reported yesterday.
The study by Scandinavian experts highlighted the dilemma facing doctors when it comes to detecting and treating breast cancer - the 'silent killer' of women, thus named for the way it can stealthily claim lives.
But not all breast cancers are life-threatening. In some cases, the cancer will grow so slowly that the patient will die of other causes before it produces symptoms, or it may remain dormant over the years or even shrink.
Because doctors have no idea whether the cancer will be lethal or harmless, they tend to treat all patients diagnosed with a tumour. But cancer treatment, using powerful drugs, radiotherapy or surgery, causes harm.
So it is vital to know how many patients may be getting unnecessary treatment, especially given the huge investment in having women undergo regular mammograms.
Dr Karsten Jorgensen and Dr Peter Gotzsche of the Nordic Cochrane Centre in Copenhagen pored over data from screening programmes done in Australia, Britain, Canada, Norway and Sweden.
They looked at trends seven years before the programmes were implemented, and seven years after.
Once screening programmes began, more cases of breast cancer were inevitably picked up, the study showed. If a screening programme is working, there should also be a drop in the number of advanced cancer cases detected in older women, since their cancers should theoretically have been caught earlier when they were screened.
However, the two experts found the national breast cancer screening systems, which usually test women aged between 50 and 69, simply reported thousands more cases than previously identified.
Overall, Dr Jorgensen and Dr Gotzsche found that one-third of the women identified as having breast cancer did not actually need to be treated.
Dr Jorgensen said that for years, women were urged to undergo breast cancer screening without them being informed of the risks involved, such as having to endure unnecessary treatment if a cancer was identified, even if it might never threaten their health.
'This information needs to get to women so they can make an informed choice,' he said. 'There is a significant harm in making women cancer patients without good reason.'
Doctors and patients have long debated the merits of prostate cancer screening out of similar concerns that it overdiagnoses patients. A study in the Netherlands found that as many as two out of every five men whose prostate cancer was caught through a screening test had tumours too slow growing to ever be a threat.
In an editorial also published by the BMJ, Professor Gilbert Welch, at the Dartmouth Institute for Health Policy and Clinical Research in Vermont, said the new findings raised the key question about the trade-off between deaths avoided and harm inflicted by screening programmes.
One study has suggested that one death is avoided for every two women who are 'overdiagnosed', while another puts the ratio far higher, at one death avoided for every 10 cases of unnecessary treatment.
Prof Welch called on the medical profession to draw up a simple statistical table to help women weigh the risks and the benefits from breast cancer treatment.
'Mammography undoubtedly helps some women but hurts others,' said Prof Welch.
'No right answer exists, instead it is a personal choice.'
AGENCE FRANCE-PRESSE, ASSOCIATED PRESS
<HR SIZE=1 width="50%">
One study has suggested that one death is avoided for every two women who are 'overdiagnosed', while another puts the ratio far higher, at one death avoided for every 10 cases of unnecessary treatment.
