Good prognosis through mammography screening

Cooperation Community Mammography presents evaluation of Europe-wide mammography screening

02/21/2014

As part of the cancer congress in Berlin, the cooperation community mammography presented a Europe-wide evaluation of mammography screening. Accordingly, many tumors are already discovered with a size of less than two centimeters in the investigation. This tumor stage is considered prognostically favorable if the lymph nodes are not affected. However, critics complain that, on the one hand, too few women save their lives through screening, and on the other hand, too many women suffer unnecessary therapies.

First evaluation of initial and follow-up examinations of mammography screening
Within a year, approximately 17,500 breast cancers were detected by breast cancer screening. Many could be discovered at a very early stage with good chances of recovery, reports the cooperation community mammography. Since the introduction of the nationwide program in Germany in 2009, not only the initial examinations but also the follow-up examinations have been considered for the first time for the 94 screening units with about 400 locations. „The data from 2.7 million studies have been evaluated for the current annual report, "reported Dr. Karin Bock from the Mammography Southwest reference center, the most meaningful of which is the results of the follow-up. „The trend of previous years is clearly confirmed. 80 percent of the invasive carcinomas are smaller than two centimeters and 78 percent have not yet attacked the lymph nodes. "These small tumors have a much more favorable prognosis than larger ones in which the lymph nodes are also affected. „We now have the certainty that the German screening is on the right track, "explained the head of department of the Mammographie cooperation group, Dr. Tatjana Heinen-Kammerer.

Effects of mammography screening on breast cancer mortality and quality of life
But not only the tumor stage distribution shows that early breast cancer detection works in Germany. „The screening does what it should. We can also see that in comparison with the current data from the cancer registry, "reports Professor Alexander Katalinic from the Institute for Social Medicine and Epidemiology of the University Medical Center Schleswig-Holstein. „First, the breast cancer incidences are increased by the screening, because one also finds tumors at an earlier stage. "Thereafter, the rate usually decreases, since the cases detected in the first screening pass are missing in the following as well as the increase and decrease in new cases, the first measurable effects of a breast cancer screening program, but only after nine to twelve years, could statements about whether the screening lead to a reduction in breast cancer mortality, the experts said. „In Germany, we will be able to say something about it at the earliest in 2018, "emphasized Katalinic. „We discuss a lot about breast cancer mortality. The 5-year survival rate has risen steadily in recent years to 87 percent. Therefore, we should use the influence of screening by finding prognostically favorable carcinomas on the quality of life much more than before as a weighting factor. "

Criticism of mammography screenings
Again and again, voices are voiced criticizing mammography screenings. According to some studies, the study saves the lives of a few women. At the same time many women undergo unnecessary therapies such as radiation or chemotherapy due to usually negligible findings. Some health experts even advise against screening programs.

Recently, a study by the Bertelsmann Stiftung and Barmer GEK showed that many women in Germany are very poorly informed about the benefits of mammography screening. the „Health monitor“ According to reports, 30 percent of women believed that participation in breast cancer screening alone prevented them from developing malignant tumors. The experts came to the conclusion that on the one hand the benefit of the investigation is overestimated, on the other hand there is little knowledge about the risks such as false positive findings. Many women are very afraid of making wrong decisions when it comes to cancer diagnosis, the authors of the report write. Professor Norbert Schmacke, who was involved in the investigation, finds the extent of the information deficit worrying. In his opinion, the screening invitations lack the necessary information and the time and opportunity to form their own opinion.

In eight out of every 1,000 women, according to the Mammography Cooperation Association, breast cancer is detected in the initial screening in mammography screening. In the following run it is 5.5. According to the Robert Koch Institute (RKI), 70,000 women are diagnosed with breast cancer each year, and about 17,500 die from it. The risk of developing breast cancer increases with age. (Ag)

Picture: Rainer Sturm