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Evaluation: There are false diagnoses in mammography screening
Although breast cancer is the cancer with the highest death rate among women in Germany, by no means all women go to mammography screening. According to experts, breast cancer can be successfully treated in most cases if diagnosed early. According to new data, there are very few errors or overdiagnoses in the screenings.
Cancer with the highest death rate
Breast cancer is the cancer with the highest death rate among women in Germany. Nationwide, around 17,000 die of it every year and around 70,000 fall ill each year. According to the German Society for Senology (DGS), around 80 percent of women who are ill can now be successfully treated. A lot depends on an early diagnosis. Since 2002 women in this country have had the opportunity to take part in the mammography screening free of charge. The examination, which is carried out on special X-ray equipment, was considered the ultimate in breast cancer screening for years. However, the pros and cons of the screening program have been controversial for years. As a new evaluation now shows, the screenings rarely lead to incorrect diagnoses.
In Germany, women aged 50 to 69 can participate in the breast cancer screening program free of charge. However, only about every second goes to mammography screening. Women are often afraid of the examination - it is not entirely painless. While it is known that the examination does not offer a guarantee, over 17,000 carcinomas were detected by mammography screenings a year alone. However, it is often criticized that the examinations also lead to many overdiagnoses.
Apparently this number is not that high. As the cooperation group mammography announced in a communication, early diagnosis of breast cancer in Germany rarely leads to false diagnoses. In total, six out of 1,000 women between the ages of 50 and 70 are diagnosed with breast cancer through systematic X-ray examinations.
Doctors have to investigate suspected breast cancer
"Mammography screening is repeatedly criticized for allegedly many false diagnoses," said Vanessa Kääb-Sanyal, branch manager of the mammography cooperation group. But the annual evaluations would show that quality assurance is particularly effective when avoiding an unnecessarily large number of false positive results.
“The doctors in the screening have to investigate every reasonable suspicion of breast cancer in order not to miss a carcinoma. On the other hand, there are very clear guidelines in the European guidelines for the number of supplementary clarification examinations, so as not to burden women unnecessarily. ”Overall, only three percent of the regular participants received an incorrect tumor diagnosis. The results are based on the most recent screening annual report for 2013.
Tumors can grow between two exams
Of the approximately 2.9 million women examined in 2013, 17,430 were diagnosed with breast cancer. Almost 129,000 of them had previously been invited again to clarify any abnormal findings. The request for clarification is a shock for many concerned. In two thirds of them, however, it was possible to give the all-clear after a short time through further examinations, for example with ultrasound. However, the suspicion persisted in around 35,000 women; around half later received the diagnosis of breast cancer. According to Corinna Heinrich, spokeswoman for the cooperation group, the main reason for the fact that only up to 80 percent - and not 100 percent - of the breast cancers are discovered during screening is that tumors can grow at intervals of two years between examinations. They could also be overlooked.
Today fewer women die from breast cancer
The screening process, which was introduced throughout Germany between 2005 and 2009, is controversial. At the earliest after ten years, there could be certain results as to whether women really have a survival advantage through the procedure. According to the Robert Koch Institute (RKI), breast cancer incidence rates in Germany have initially skyrocketed since 2005, but have declined slightly since 2009. "This indicates that in the first phase of the program, many tumors were discovered much earlier than without screening," write the RKI experts. It is known that tumors in the age group of 50 to 70 year olds are detected by screening at an earlier and smaller stage than before the start of the screening. In addition, despite increasing numbers of cases, fewer women are dying from breast cancer than ten years ago, according to the RKI. Advances in therapy would have significantly improved the chances of survival. However, screening would also likely diagnose some tumors that would otherwise have remained undetected for life and would not have caused any symptoms.
Experts estimate the radiation risk in X-ray examinations to be significantly lower than it was 20 years ago because of modern equipment. The question of whether the benefits of the examination outweigh the risk of exposing predominantly healthy women to X-rays cannot be answered conclusively. (ad)