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Mortality rate is key number on breast cancer

DR. DONALD A. Taylor's letter "Mammograms have stood, and aced, the test of time" (April 16) requires a response. Taylor's case for the benefits of mammography rests largely on his assertion that the five-year survival rates for those diagnosed with breast cancer have risen substantially since screening mammography was introduced. This is correct.

Left unspoken was how meaningless these five-year survival rates are. Women whose breast cancer is detected earlier with mammography will be alive five years later than those detected with a more advanced stage of the disease, but do they live any longer?

If mortality rates are no different, women aren't living any longer but merely are aware longer that they have breast cancer. These women undergo more medical interventions than women whose breast cancer is discovered later. The current arrangement isn't bad for those in the business of providing those medical interventions, but is of no real benefit — and could cause harm — if the patient is on the receiving end.

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On the same day that Taylor’s letter was published, The New England Journal of Medicine published an article on the Swiss Medical Board’s recent finding on the impact of routine mammography screening. The Swiss researchers found that for every thousand women screened, one at most avoided death by breast cancer. “A public health program that does not clearly produce more benefits than harms is hard to justify,” the article concludes.

Yet surveys show that most women believe the lives of 80 women per thousand are saved by screening mammography. This hugely inflated public perception of mammography benefits is fueled by those who cherry-pick the data to support their cause.

John A. Lynch
Hopkinton