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Is routine screening for breast cancer for asymptomatic women younger than 50 worthwhile?

Dr. Mercola seems pretty confident that mammography not only doesn't improve breast cancer outcomes, but likely causes more cancer than it prevents. See here and here, for typical articles on the subject from his site. Is he right?

Conventional advice, of course, is to get a mammogram every year or two. This is of more than academic concern, because I need to advise the women in my life what to do.

  • The linked question seems to cover the same ground. – Sklivvz May 8 '12 at 12:35
  • It covers the same topic, yes, but doesn't specifically refute the claims made by Dr. Mercola, which are the ones making me question whether mammograms are safe or useful. Could we leave this open for a little while to give people the chance to weigh in on these specific articles? – Joshua Frank May 8 '12 at 12:42
  • @JoshuaFrank-- I would end up posting the same response, probably :) Dr. Mercola does not seem to remember that the second leading cause of death among women is cancer (cdc.gov/women/lcod), and the leading cancer among women is breast cancer (cdc.gov/cancer/dcpc/data/women.htm). Women who don't get screened die at the rates of women who died prior to the introduction of the mammogram as a screening tool (asco.org/ascov2/Meetings/…). Mammograms save lives; frequency is up for discussion. – mmr May 8 '12 at 16:59
  • The question here differs in a subtle way to the other question. This question is more specific about the cause of screening failure. There are many more reasons for possible harm as a result of screening and the question might be worth retaining if the focus is to look at the evidence of excess cancer risk only. – matt_black May 8 '12 at 22:32
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    @JoshuaFrank-- he is wrong about that. ACRIN 6666 (acrin.org/Portals/0/Protocols/6666/…) showed that ultrasound can augment but cannot replace mammograms, especially when the addition of ultrasound increased the false positive rate by 4x. Since Dr. Mercola is concerned about the effects of false positives (ie, the incorrect need for biopsy, etc), this increase would seem to invalidate his argument that alternative screening methods are more helpful. – mmr May 9 '12 at 3:10

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