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You probably have heard about the new Swedish study of mammograms that appeared in the journal Cancer last week. It seemed to suggest that an average-risk woman in her 40s would benefit from routine mammograms—contrary to the U.S. Preventive Service Task Force’s latest recommendation.
But over at the HealthNewsReviewBlog Gary Schwitzer points to some curious caveats in major news stories about the study. His team reviewed four stories and found that:

“Three of the four stories gave a pretty clear indication that there were methodological concerns about the Swedish research. (Only HealthDay - of the four we reviewed - offered no such hint.)

“• 4th paragraph of AP story: ‘The new study has major limitations and cannot account for possibly big differences in the groups of women it compares.’

“• 1st paragraph of LA Times blog story: ‘Critics charged that the study was poorly designed and potentially vastly misleading.’

“• 2nd sentence of NY Times story: ‘Results were greeted with skepticism by some experts who say they may have overestimated the benefit.’”

Unfortunately, “none of the stories did a very complete job of explaining those potential limitations,” Schwitzer writes. “Because of the confusion that must be occurring in the minds of women - especially those in their 40s - this is a time in which journalism must rise to the need and do a better job of evaluating evidence and helping readers make sense of what appear to be conflicting findings.

“I was in Chapel Hill, North Carolina when the study was published,” he continues “ and had the chance to talk about it with former US Preventive Services Task Force member, and a recognized thought leader on issues of prevention and especially of screening tests, Dr. Russell Harris, Professor and Director of the Health Care & Prevention Concentration of the University of North Carolina School of Public Health.

“He sent me an email with the following analysis of the study. Read this carefully. I'm confident you'll learn a great deal from his analysis.”

To read Harris’ analysis, go to Schwitzer’s blog.

What is most important, I think, is to recognize that mammograms carry risks as well as benefits—not just the risk of a false positive, but the danger that discovery of a tiny tumor that would have disappeared leads to treatment. Sometimes, this means that a woman undergoes an unnecessary mastectomy or lumpectomy.

Naomi and I have both written about this danger, most recently here where I note that the danger that a woman will lose all or part of a breast needlessly is growing. Advances in mammography and other advanced imaging technology over the past 30 years have meant that pathologists wind up rendering opinions on ever-smaller breast lesions, some the size of a few gains of salt.

Just how often are women misdiagnosed? According to the National Institute of Health (NIH) diagnosis of non-invasive breast cancer was rare, until the 1980s, when mammograms become popular. Now, 50,000 women are diagnosed with these small lesions (ductal carcinoma in situ, or DCIS) each year.
The question each woman has to ask herself is this: does the magnitude of the potential benefit equal the magnitude of the risk?

While analyzing the Swedish study Harris also underlines significant methodological problems.

Suffice to say, this new study does not end the debate.

Read More: http://www.healthbeatblog.com/2010/10/swedish-study-of-mammograms-for-women-under-50.html