Breast cancer screening not absolute

DUE to the high number of premature deaths from breast cancer in Irish women, there have recently been calls for screening units in Waterford and Kilkenny.

While every preventative effort that helps to reduce the number of cancer victims must be supported, the case for breast screening units is not as absolute as we think.

We could be terrorising women into a state of hysteria, where they are prepared to submit to a medical regime of chemotherapy, radiotherapy and surgery, which can contribute to premature death.

Not all breast lumps are malignant. According to a study from the Nordic Cochrane Centre in Copenhagen, routine breast cancer screening of women over 50 does not reduce deaths. It may actually do harm, the study suggests, because it often leads to surgery to remove tumours, some of which are so slow-growing that they never would have developed into cancer in the women’s lifetimes.

In a 2002 Journal of the American Medical Association, Dr Barbara Starfield warned that one cause of medical mistakes is the overuse of technology which may create a “cascade effect” leading to more treatment.

Starfield says that, at present, deaths due to medical error are likely to be coded according to some other cause of death.

Until the mid-1980s, drug firms were not required to prove that their toxic products prolonged survival or provided better quality of life. In cancer drug trials, all that was required was a small study showing that the drug had caused a tumour to shrink but not necessarily to disappear.

Shrinkage often bears little or no relation to survival. From 1990 to 2001, no proof of prolonged survival was proven for 48 of the 66 new cancer drugs approved. The possible benefit of tumour shrinkage did not necessarily outweigh the hazard of many cancer drugs’ substantial toxicity.

Patrick J Carroll

Lady Lane House

Waterford