What is it about?
New research involving over 2.4 million pre and postmenopausal women without prior invasive breast cancer (IBC) diagnosis at enrollment, has shown that over 99.7% of them continued to remain IBC-free each year. Even after 25 years, 93.41% of such women remain free from invasive breast cancer. These findings suggest that the frequency of mammograms for menopausal women without a history of IBC could be safely reduced. This study provides valuable insights that can help minimize overdiagnosis, subsequent overtreatment, and reduce unnecessary interventions.
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Photo by National Cancer Institute on Unsplash
Why is it important?
Prior studies have revealed that, in over 20 years of follow-up, early detection of invasive breast cancer (IBC) does not save lives. Moreover, about half of early-stage IBC cases regress spontaneously or do not progress further on their own, and their early detection provokes a plethora of treatments that are harmfully reducing long-term quality of life, mental health, and well-being. In other words, these cases, if detected early, may lead to unnecessary and potentially harmful treatments with long-term negative repercussions for the patient. This new paper builds on those previous studies by documenting and extending the absence of IBC after 25 years of follow-up. Taken together, these vital results for pre and postmenopausal women challenge the conventional belief surrounding early detection of IBC. This research is significant in the field of breast cancer and provides critical insights for healthcare professionals, policymakers, and patients. These new findings are more vital now than ever because the number of pre and postmenopausal women that can afford new and increasingly popular technologies in the world has increased substantially, but some of these technologies have made the problem worse. For example, the emergence of digital 3D mammography (also known as tomosynthesis) has doubled the rate of radiation-induced breast cancer. In other words, healthy women that screen are at greater risk than ever of developing serious breast cancer as a result of such screening.
Perspectives
Early detection can come with many more potential risks, harms, and negative consequences than the obvious ones. These include overdiagnosis (increasing over time), a substantial false positive rate, overtreatment with potential toxic effects of surgery, radiation, chemotherapy, or hormone therapy, radiation-induced breast cancer (about 125 cases per 100K screens, doubled by digital tomosynthesis, which employs x-rays), chronic psychological and physical distress, and other treatment-related side effects (such as genitourinary syndrome, affecting the urinary and genital systems). Additionally, there are high treatment costs, conflicts of interest, loss of income for patients, and issues with biased informed consent lacking proper warning and understandability, among others. The combination of these factors is deeply concerning and requires awareness among women at risk worldwide.
Dr. Hugo Moises Montesinos-Yufa
Ursinus College
Read the Original
This page is a summary of: Long term absence of invasive breast cancer diagnosis in 2,402,672 pre and postmenopausal women: A systematic review and meta-analysis, PLoS ONE, September 2020, PLOS,
DOI: 10.1371/journal.pone.0237925.
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