Screening Mammography: Update and Review of Publications Since Our Report in the New England Journal of Medicine on the Magnitude of the Problem in the United States

Published:November 05, 2015DOI:
      Because the four letters of correspondence describe a variety of concerns, I have organized them according to their general topic and in some instances re-emphasized data from the original reports (
      • Bleyer A.
      • Welch H.G.
      Effect of three decades of screening mammography on the incidence of breast cancer.
      • Bleyer A.
      Were our estimates of overdiagnosis with mammography screening in the United States “based on faulty science?”.
      • Bleyer A.
      Screening mammography: update and review of publications since our report in the New England Journal of Medicine on the magnitude of the problem in the United States.
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        • Bleyer A.
        • Welch H.G.
        Effect of three decades of screening mammography on the incidence of breast cancer.
        NEJM. 2012; 367: 1998-2005
        • Bleyer A.
        Were our estimates of overdiagnosis with mammography screening in the United States “based on faulty science?”.
        Oncologist. 2014; 19: 113-126
        • Bleyer A.
        Screening mammography: update and review of publications since our report in the New England Journal of Medicine on the magnitude of the problem in the United States.
        Acad Radiol. 2015; 22: 949-960
        • Helvie M.A.
        • Chang J.T.
        • Hendrick R.E.
        Reply to flawed assumptions used to defend screening mammography.
        Cancer. 2015; 121: 321-323
        • Heston J.F.
        • Cusano M.M.
        • Young J.L.
        • et al.
        Forty-five years of cancer incidence in Connecticut: 1935–1979.
        Natl Cancer Inst Monogr. 1986; 70: 1-706
        • Howard J.
        Using mammography for cancer control: an unrealized potential.
        CA Cancer J Clin. 1987; 37: 33-48
        • Shapiro S.
        The status of breast cancer screening: a quarter of a century of research.
        World J Surg. 1989; 13: 9-18
        • Devesa S.S.
        • Silverman D.T.
        • Young J.L.
        • et al.
        Cancer incidence and mortality trends among whites in the United States, 1947-84.
        J Natl Cancer Inst. 1987; 79: 701-770
        • Christiansen P.
        • Vejborg I.
        • Kroman N.
        • et al.
        Position paper: breast cancer screening, diagnosis, and treatment in Denmark.
        Acta Oncol. 2014; 53: 433-444
        • Sigurdsson K.
        • Olafsdottir E.J.
        Population-based service mammography screening: the Icelandic experience.
        Breast Cancer (Dove Med Press). 2013; 5: 17
      1. Demographics of Iceland.
        (Available at:) (Accessed August 3, 2015)
        • Cronin K.A.
        • Feuer E.J.
        • Clarke L.D.
        • et al.
        Impact of adjuvant therapy and mammography on U.S. mortality from 1975 to 2000: comparison of mortality results from the CISNET breast cancer base case analysis.
        J Natl Cancer Inst Monogr. 2006; : 112-121
        • Yankaskas B.C.
        Epidemiology of breast cancer in young women.
        Breast Dis. 2005-2006; 23: 3-8
        • Collaborative Group on Hormonal Factors in Breast Cancer
        Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease.
        Lancet. 2002; 360: 187-195
        • Helewa M.
        • Lévesque P.
        • Provencher D.
        • et al.
        Breast cancer, pregnancy, and breastfeeding.
        J Obstet Gynaecol Can. 2002; 24: 164-180
        • Etzioni R.
        • Xia J.
        • Hubbard R.
        • et al.
        A reality check for overdiagnosis estimates associated with breast cancer screening.
        J Natl Cancer Inst. 2014; 106
        • Baker S.G.
        • Prorok C.
        • Kramer B.S.
        Lead time and overdiagnosis.
        J Natl Cancer Inst. 2014; 106: dju346
      2. Use of mammography among women 40 years of age and over, by selected characteristics: United States, selected years 1987–2008.
        (Table 86 (page 1 of 3). Atlanta: Centers for Disease Control and Prevention. Available at:) (Accessed August 4, 2015)
      3. Breast Cancer Surveillance Consortium mammography data.
        (Available at:) (Accessed August 4, 2015)
        • Seidenwurm D.
        Counterpoint: the New England Journal of Medicine article suggesting overdiagnosis from mammography screening is scientifically correct and should not be withdrawn.
        J Am Coll Radiol. 2013; 10: 320-323
      4. Surveillance, Epidemiology, and End Results (SEER) Program.
        (SEER*Stat Database: Incidence—SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, Nov 2014 Sub (1973-2012 varying)—Linked To County Attributes—Total U.S., 1969-2013 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2015, based on the November 2014 submission. Available at:) (Accessed August 4, 2015)
        • Brodersen J.
        • Jørgensen K.J.
        The balance is shifting away from screening.
        Clin Adv Hematol Oncol. 2014; 12: 407-409
        • Harding C.
        • Pompei F.
        • Burmistrov D.
        • et al.
        Breast cancer screening, incidence, and mortality across U.S. counties.
        JAMA Intern Med. 2015; 175 (Published online July 6, 2015): 1483-1489
      5. Appendix of randomized controlled trials.
        (Available at) (Accessed August 4, 2015)
        • Miller A.B.
        • Wall C.
        • Baines C.J.
        • et al.
        Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial.
        BMJ. 2014; 348: g366
        • Gøtzsche P.C.
        • Nielsen M.
        Screening for breast cancer with mammography (Review).
        Cochrane Database Syst Rev. 2011; (CD001877)
        • Marmot M.G.
        Sorting through the arguments on breast screening.
        JAMA. 2013; 309: 2553-2554
        • Newman D.H.
        Screening for breast and prostate cancers. Moving toward transparency.
        J Natl Cancer Inst. 2010; 102: 1008-1011
      6. Breast cancer screening for health professionals: Benefits of screening: Randomized controlled trials; Summary.
        (Available at:) (Accessed August 4, 2015)
        • Walter L.C.
        • Schonberg M.A.
        Screening mammography in older women: a review.
        JAMA. 2014; 311: 1336-1347
        • Lee S.J.
        • Boscardin W.J.
        • Stijacic-Cenzer I.
        • et al.
        Time lag to benefit after screening for breast and colorectal cancer: meta-analysis of survival data from the United States, Sweden, United Kingdom, and Denmark.
        BMJ. 2013; 346: e8441
        • Osler W.
        The medical aspects of carcinoma of the breast, with a note on the spontaneous disappearance of secondary growths.
        Amer Med Phila. 1901; 17: 63-66
        • Osler W.
        An address on the medical aspects of carcinoma of the breast.
        Br Med J. 1906; 1: 1-4
        • Rohdenburg G.L.
        Fluctuations in the growth energy of tumors in man, with special reference to spontaneous recession.
        J Cancer Res. 1918; 3: 193-225
        • Fauvet J.
        • Roujeau J.
        • Piet R.
        Spontaneous cancer cures and regressions.
        Rev Prat. 1964; 14 (in French): 2177-2180
        • Challis G.B.
        • Stam H.J.
        The spontaneous regression of cancer. A review of cases from 1900 to 1987.
        Acta Oncol. 1990; 29: 545-550
        • Nielsen M.
        • Thomsen J.L.
        • Primdahl S.
        • et al.
        Breast cancer and atypia among young and middle-aged women: a study of 110 medicolegal autopsies.
        Br J Cancer. 1987; 56: 814-819
      7. Cancer Query System: probability of developing or dying of cancer.
        (Available at:) (Accessed August 3, 2015)
        • Bhathal P.S.
        • Brown R.W.
        • Lesueur G.C.
        • et al.
        Frequency of benign and malignant breast lesions in 207 consecutive autopsies in Australian women.
        Br J Cancer. 1985; 51: 271-278
        • Alpers C.E.
        • Wellings S.R.
        The prevalence of carcinoma in situ in normal and cancer-associated breasts.
        Hum Pathol. 1985; 16: 796-807
      8. Breast screening: helping you decide.
        (National Health Service. NHS Cancer Screening Programmes 2901195, pp. 9–11. Available at:) (Accessed August 4, 2015)
        • Research Council of Norway
        Research-based evaluation of the Norwegian Breast Cancer Screening Program Final report.
        (The Research Council of Norway, Oslo, May; p. 9. Available at:) (Accessed August 4, 2015)
        • Woods W.G.
        Substitute “prostate cancer” for “neuroblastoma?”.
        J Clin Oncol. 2002; 20: 1154-1155
        • Patz E.F.
        • Pinsky P.
        • Gatsonis C.
        • et al.
        Overdiagnosis in low-dose computed tomography screening for lung cancer.
        JAMA Intern Med. 2014; 174: 269-274
        • Weyers W.
        The “epidemic” of melanoma between under- and overdiagnosis.
        J Cutan Pathol. 2012; 39: 9-16
        • Spix C.
        • Michaelis J.
        • Berthold F.
        • et al.
        Lead-time and overdiagnosis estimation in neuroblastoma screening.
        Stat Med. 2003; 22: 2877-2892
        • Loeb S.
        • Bjurlin M.A.
        • Nicholson J.
        • et al.
        Overdiagnosis and overtreatment of prostate cancer.
        Eur Urol. 2014; 65: 1046-1055
        • O'Grady T.J.
        • Gates M.A.
        • Boscoe F.P.
        Thyroid cancer incidence attributable to overdiagnosis in the United States 1981-2011.
        Int J Cancer. 2015; 137: 2664-2673