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Earlier this year, a study by an independent panel of researchers sparked an international debate about the effectiveness of mammograms in preventing breast cancer deaths.
Despite the controversy, mammograms still represent an important screening tool for women. "There is absolutely no reason for a woman to change her already-established pattern for obtaining mammograms," says Maurie Markman, M.D., director of The Cleveland Clinic Cancer Center.
Rather than anecdotal evidence, the study was based on fewer than a dozen major clinical trials. Since mammography has become an accepted screening tool, both tumor size at the time of detection and the rate of death from breast cancer have steadily declined.
"Substantial data exist to suggest mammography is beneficial, even if there are some concerns with the design of clinical trials conducted more than a decade ago," says Dr. Markman.
A second major study from Sweden, which was published in the medical journal The Lancet, followed shortly after the first and reaffirmed that regular mammography screening reduces rates of breast cancer death by nearly 20 percent.
The use of screenings for other cancers -- specifically cervix and colon -- is quite strong, adds Cleveland Clinic internist Richard Lang, M.D., M.P.H. "It's difficult to find fault with the reasonable recommendations made by various organizations, including the American Cancer Society."
"The bottom line," says Dr. Markman, "is that death rates from breast cancer in both the United States and Europe have decreased by almost 30 percent over the past decade."
Is the decrease due to early detection through the use of mammograms or to better treatment once cancer is detected?
"There is no question that early detection of cancer is key to survival," he says. "Because mammography allows us to detect tumors much earlier than traditional breast exams, we are able to offer patients more treatment options."
The science of mammography is not flawless, adds Dr. Markman. "However, its use allows for early detection of cancer, and early detection does save lives."
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