The Breast Cancer Overdiagnosis Conundrum: An Oncologist's Viewpoint
Authors: Henry G. Kaplan, Judith A. Malmgren
Journal: Annals of Internal Medicine (2013)

Ideas and Opinions1 January 2013The Breast Cancer Overdiagnosis Conundrum: An Oncologist's ViewpointHenry G. Kaplan, MD and Judith A. Malmgren, PhDHenry G. Kaplan, MDFrom the Swedish Cancer Institute; HealthStat Consulting; and School of Public Health and Community Medicine, University of Washington, Seattle, Washington. and Judith A. Malmgren, PhDFrom the Swedish Cancer Institute; HealthStat Consulting; and School of Public Health and Community Medicine, University of Washington, Seattle, Washington.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-1-201301010-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Controversy about the appropriate age to begin and the frequency of mammography screening for breast cancer has been ongoing. The U.S. Preventive Services Task Force (USPSTF) has recommended that screening begin at an older age and at longer intervals than had been previously recommended (1). The change was prompted by evaluation of reports that screening mammography as currently practiced in the United States is associated with needless work-ups and attendant complications, resulting in the Task Force's conclusion that the harms outweigh the benefits for women aged 40 to 49 years and that screening could be reduced to every other year ...References1. U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151:716-26. [PMID: 19920272] LinkGoogle Scholar2. Erbas B, Provenzano E, Armes J, Gertig D. The natural history of ductal carcinoma in situ of the breast: a review. Breast Cancer Res Treat. 2006;97:135-44. [PMID: 16319971] CrossrefMedlineGoogle Scholar3. Kalager M, Adami HO, Bretthauer M, Tamimi RM. Overdiagnosis of invasive breast cancer due to mammography screening: results from the Norwegian screening program. Ann Intern Med. 2012;156:491-9. [PMID: 22473436] LinkGoogle Scholar4. Smith RA, Duffy SW, Tabár L. Breast cancer screening: the evolving evidence. Oncology (Williston Park). 2012;26:471-5, 479-81, 485-6. [PMID: 22730603] MedlineGoogle Scholar5. Gerlinger M, Rowan AJ, Horswell S, Larkin J, Endesfelder D, Gronroos E, et al. Intratumor heterogeneity and branched evolution revealed by multiregion sequencing. N Engl J Med. 2012;366:883-92. [PMID: 22397650] CrossrefMedlineGoogle Scholar6. Malmgren JA, Atwood MK, Kaplan HG. Increase in mammography detected breast cancer over time at a community based regional cancer center: a longitudinal cohort study 1990-2005. BMC Cancer. 2008;8:131. [PMID: 18471303] CrossrefMedlineGoogle Scholar7. Swedish Organised Service Screening Evaluation Group. Effect of mammographic service screening on stage at presentation of breast cancers in Sweden. Cancer. 2007;109:2205-12. [PMID: 17471486] CrossrefMedlineGoogle Scholar8. Kaplan HG, Malmgren JA. Disease-specific survival in patient-detected breast cancer. Clin Breast Cancer. 2006;7:133-40. [PMID: 16800972] CrossrefMedlineGoogle Scholar9. Esserman LJ, Shieh Y, Rutgers EJ, Knauer M, Retél VP, Mook S, et al. Impact of mammographic screening on the detection of good and poor prognosis breast cancers. Breast Cancer Res Treat. 2011;130:725-34. [PMID: 21892702] CrossrefMedlineGoogle Scholar10. Malmgren JA, Parikh J, Atwood MK, Kaplan HG. Impact of mammography detection on the course of breast cancer in women aged 40-49 years. Radiology. 2012;262:797-806. [PMID: 22357883] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Henry G. Kaplan, MD; Judith A. Malmgren, PhDAffiliations: From the Swedish Cancer Institute; HealthStat Consulting; and School of Public Health and Community Medicine, University of Washington, Seattle, Washington.Financial Support: By the Kaplan Cancer Research Fund.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1538.Corresponding Author: Henry G. Kaplan, MD, 1221 East Madison Street, Seattle, WA 98104; e-mail, [email protected].Current Author Addresses: Dr. Kaplan: 1221 East Madison Street, Seattle, WA 98104.Dr. Malmgren: HealthStat Consulting, 12025 9th Avenue NW, Seattle, WA 98177.Author Contributions: Conception and design: H.G. Kaplan, J.A. Malmgren.Analysis and interpretation of the data: H.G. Kaplan, J.A. Malmgren.Drafting of the article: H.G. Kaplan, J.A. Malmgren.Critical revision of the article for important intellectual content: H.G. Kaplan, J.A. Malmgren.Final approval of the article: H.G. Kaplan, J.A. Malmgren.Provision of study materials or patients: H.G. Kaplan.Statistical expertise: J.A. Malmgren.Obtaining of funding: H.G. Kaplan.Administrative, technical, or logistic support: H.G. Kaplan.Collection and assembly of data: H.G. Kaplan, J.A. Malmgren. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBreast cancer distant recurrence lead time interval by detection method in an institutional cohortUsing multiscale texture and density features for near-term breast cancer risk analysisMolecular breast imaging: an emerging modality for breast cancer screeningImproved Prognosis of Women Aged 75 and Older with Mammography-detected Breast CancerContralateral prophylactic mastectomy in an Asian population: A single institution review 1 January 2013Volume 158, Issue 1Page: 60-61KeywordsBiopsyBreast cancerCancer screeningCancer treatmentGeneticsLesionsMammographyMortalityPopulation statisticsToxicity ePublished: 1 January 2013 Issue Published: 1 January 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...