Opinions differ wildly in Switzerland about the use of early cancer detection programmes. Some cantons are convinced that they save lives and offer their populations screening programmes across the board. Other cantons opt not to offer them.
A mammogram is an X-ray examination of the breasts of women from the age of 50 in an attempt to detect breast tumours as early as possible, thus improving the chances of healing. But what are the real benefits of a mammography exam, and what possible damage can be done?
As it is often impossible to provide general answers to medical questions, transparent and reliable information is important. To help you weigh the benefits and risks of a mammogram, we give the facts here, in collaboration with the Harding Center for Risk Literacy. A well-structured overview is provided of the most important advantages and disadvantages.
Long-term studies were carried out during which thousands of women over 50 either did or did not undergo regular screening. The figures refer to women older than 50* who participated in mammography screening for 10 years or more (screening group) and a group consisting of the same number of women who did not participate in any screening (comparison group).
The assessment of the scientific results shows that regular mammograms reduced the number of women who died from breast cancer in a period of 10 years from 5 to 4 women out of 1,000. This did not have any impact on the total cancer mortality rate: in both groups, the same number of women died from cancer during this period.
Out of 1,000 women in the screening group, 100 women had at least one abnormal result in 10 years, although it was confirmed later that they did not have breast cancer. Some of these women had to live with uncertainty for many months and submit to further diagnostic tests until they could be confirmed to be healthy.
Mammograms also detect “indolent” tumours (tumours that grow slowly or are less aggressive) that never develop into life-threatening cancer. As the development of indolent or life-threatening tumours cannot be predicted, 5 out of 1,000 women in the screening group underwent partial or total mastectomy, even though this was unnecessary.
In Switzerland the compulsory health insurance pays for mammography screening. In some cantons running cantonal detection programmes, no deductible is payable.
The Swiss Medical Board did not favour the introduction of a systematic mammography screening programme in its report of December 2013, and recommended giving patients a thorough medical check-up and information on the positive and negative effects before doing any kind of mammogram.
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