Cancer treatment, particularly breast cancer treatment, is one of the hottest topics in modern medicine, partially due to the fact that incidence rates for many cancers are rising across the world. One of the long-standing medical diagnostic procedures associated with breast cancer is the mammogram: an X-ray image of the breast tissue used as a screening procedure in women that are not showing any symptoms of breast cancer.
A recent study published in the British Medical Journal called the practice of screening mammograms into question. Understandably, the medical community and the public at large have some important questions: are mammograms really necessary? Are mammograms more effective than regular breast exams by trained nurses? Do mammograms contribute to breast cancer risk? The study examined breast cancer diagnostic practices in the modern era, with the researchers separating thousands of Canadian subjects into a few distinct categories: 1) women who have regular mammograms and breast exams by trained medical professionals and 2) women who have only breast exams (without an accompanying mammogram).
Researchers sought to determine which method was the more effective cancer treatment while simultaneously accounting for patient risk. Particular attention was given to whether or not there were advantages to finding and treating breast cancers while they were still too small to feel. Generally, these small cancers are found during screening mammograms and women can often undergo harsh treatments (chemotherapy or radiation therapy) for cancers that do not pose a significant risk to their health.
The 25-year study of women ages 40-59 gathered some surprising results: 1) 44,925 women received both regular breast exams and mammograms, with 3,250 of these women eventually being diagnosed with breast cancer, and 500 dying from their diagnosis and 2) 44,910 women received breast exams alone, with 3,133 women eventually diagnosed with breast cancer and 505 women died following diagnosis. With the difference between the two groups miniscule it appears that medical researchers will have great difficulty accounting for the variables that caused it.
What does this study mean for breast cancer treatment? Doctors will likely still continue to prescribe mammograms, given that the cumulative radiation from the annual procedure is unlikely to produce breast cancer in someone who would not already have had a genetic predisposition. Mammograms can still find cancers that nurses may miss, though these cancers may not pose a risk to a woman’s health for some time. Medical researchers are hard at work finding “smarter” drugs and cancer treatment methods, including methods using nanotechnology, a scientific field that focuses on changing the properties of matter at an extremely small scale. Nanotechnology is being integrated into the drug delivery process so that physicians are better able to discern between malignant tumors and the healthy tissue surrounding them.