Baptism by Fire
Almost 45 years after publication in JAMA of the results of the first randomized controlled trial of screening mammography in the U.S. by Shapiro, Strax and Venet in 1971, the war continues to rage. As detailed by Dr. Barron H. Lerner in the 2001 book The Breast Cancer Wars: Hope, Fear, and Pursuit of a Cure of Twentieth-Century America, screening mammography has had its critics and detractors from the start.
The latest artillery fire comes from Switzerland, where a panel made the startling recommendation to put a halt to screening mammography in that country, first by stopping any new programs, and secondly, by putting a time limit on current programs. Not surprisingly, the panel caused a furor in that country, including outrage from cancer experts in that country.
While there have been periods of relative quiet and consensus since 1971, the present certainly is not one of them. We are seeing everything from calls to end screening mammography to recommendations that women talk with their physicians regarding whether they should receive a mammogram, which the ACR supports. I can’t help but wonder what those family physicians will say when the same old data from studies conducted on outdated technology is interminably recycled in various meta-analyses.
If we need a time limit on anything in screening mammography that would be the continued reliance on studies conducted on outdated mammography equipment.
Vice President, Executive Editor, Radiology Business
Cheryl began her career in journalism when Wite-Out was a relatively new technology. During the past 16 years, she has covered radiology and followed developments in healthcare policy. She holds a BA in History from the University of Delaware and likes nothing better than a good story, well told.