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More News About Breast Cancer

January 25, 1997

"AT the present time, the available data do not warrant a single recommendation for mammography for all women in their 40s. Each woman should decide for herself whether to undergo mammography." So concluded a panel of health experts and consumer representatives, convened by the National Institutes of Health, on January 23.

Debate about mammography and breast cancer was already contentious prior to the panel's statement. Some argue that not undergoing mammography could cost women harboring cancer cells their lives. Others worry that women in their forties who opt for regular screening are likely to end up submitting to radical and potentionally dangerous treatments for irregularities that in many cases will turn out to have been harmless.

In June, 1996, Dr. David Plotkin, the director of a cancer-research foundation in California, argued in an Atlantic cover story ("Good News and Bad News About Breast Cancer") that mammography often leads women with harmless tumors to undergo traumatizing treatment, and that even when serious cases of metastatic cancer are detected by mammography, there is still very little that can be done:

Mammography is only leading physicians to diagnose an ever-larger number of harmless tumors. Patients who otherwise would never have known they have cancer may needlessly suffer through the unique pain, anxiety, disfigurement, and expense associated with modern medicine and cancer. For all we know, the chief effect of mammography has been to disguise our inability to cure the old cancer, by burying it in cases of new cancer.

Plotkin's contention inspired both critical and laudatory letters to the editor, all of which suggest that questions of early-screening's risks and benefits are likely to remain unsettled and controversial for some time.

See the Flashbacks archive.

Copyright © 1997 by The Atlantic Monthly Company. All rights reserved.
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