BENEFITS VERSUS RISKS FROM MAMMOGRAPHY - A CRITICAL REASSESSMENT

BACKGROUND. The use of mammography has increased rapidly over the last decade. The justification for mammographic examinations is the potent ial benefit they provide in detecting breast cancer at an early stage and reducing mortality. However, this benefit must be balanced against the associated potential risk of radiation carcinogenesis, economic c osts, and a number of other factors. Most publications to date have us ed radiation risk factors and data from studies that were published ov er a decade ago, which now have been superseded by the results of more recent epidemiological studies. METHODS. This report examines the cur rent literature regarding the benefits of cancer detection and the ris k of radiation carcinogenesis, and calculates the ratio of benefit and risk for women who begin annual mammography screening at different ag es. We have used current data to calculate the expected individual ben efits and radiation risks associated with annual mammographic screenin g. RESULTS. It now appears that there is little risk of breast cancer associated with radiation exposure from annual mammography in women ov er the age of 35, although there is some indication that exposure of y ounger women may pose a risk for those women in a genetically sensitiv e subgroup. CONCLUSIONS. New data document that for a woman beginning annual mammographic screening at age 50 and continuing until age 75, t he benefit exceeds the radiation risk by a factor of almost 100. Even for a woman who begins annual screening at age 35 and continues until age 75, the benefit of reduced mortality is projected to exceed the ra diation risk by a factor of more than 25. (C) 1996 American Cancer Soc iety.