Breast Cancer Is Being Overdiagnosed and Overtreated – Why?

The question of whether the benefits of breast cancer screenings have gradually waned to the point where they are no longer outweighed by the costs of overdiagnosis and overtreatment is brought up by a new research.

Breast cancer testing is expensive. A Danish/Norwegian research that looked at 10,580 breast cancer deaths among Norwegian women between the ages of 50 and 75 demonstrated this.

"As cancer treatments advance, the screening's positive impact is currently decreasing. The death rate for breast cancer has nearly decreased in half over the past 25 years, according to the study's lead author, Henrik Stvring.

Researchers claim that the problem is that screenings lead to overdiagnosis and overtreatment, which has a cost on both a human and financial level.

Overtreatment and overdiagnosis

When screening was originally introduced, it was predicted that about 20% of fatalities among those who underwent screening may have been prevented. In Denmark, this amounted to about 220 deaths annually 25 years ago, but the number has now been slashed in half.

The study found that although it took 731 women in Norway in 1996 to prevent one breast cancer death, it would take at least 1364 and probably closer to 3500 women to achieve the same effect in 2016.

However, the detrimental effects of screening continue to exist.

According to the study, one in five women aged 50 to 70 who obtain a breast cancer diagnosis got a diagnostic that was "superfluous" since they would not have known they had the disease if they hadn't undergone screening.

In Denmark, one in five is equal to 900 women each year. Additionally, more than 5000 women are informed annually that the screening has raised a breast cancer suspicion that later proves to be unfounded.

Small, peaceful nodes, but in whom?

Henrik Stvring points out that the outcome is not good for the screening initiatives. He thinks that Denmark may also use the findings from Norway. Every two years, mammography screenings are available for women between the ages of 50 and 69 here. An X-ray of the breast is being done to see whether the woman has any cellular abnormalities that might be breast cancer.

In 2007, three years after the Norwegians, the Danish screening program was made available to all women in the age range on a nationwide level. Every year, around 300,000 Danish women are invited to breast cancer screenings.

The difficulty, according to the researcher, is that we can't yet distinguish between tiny cancer tumors that will kill you and those that won't. If the woman had not been screened, several of these tiny nodes would be so quiet or slow-growing that she would have died naturally from breast cancer. However, if a cancer node has been identified, it must of course be treated, even though some of the women — we just don't know which ones — did not require therapy.

According to Henrik Stvring, "The women who are invited to screening live longer because all breast cancer patients survive longer, and because we have better treatments, more effective chemotherapy, and cancer care pathways, which means the healthcare system reacts faster than it did a decade ago."