Why are the Swiss Abolishing Mammograms?

Hello bOOb Bloggettes:

It might surprise many of you to know (it did me) that the Swiss are phasing-out mammography due to its detriments. Let’s look at what they based their decision on.

Some prominent studies were concluded, and a meta-analysis was performed by the Nordic Cochrane Centre — thought to be the world’s finest research center and most unbiased — which caught medicine’s eye around the globe. After extensive review of the literature, one of the founders of Cochrane wrote this in The Lancet medical journal in 2000: “Screening for breast cancer with mammography is unjustified.”  They believed that as many women were being harmed by mammograms as were being “saved” through early detection.

Look at this part of the Cochrane Centre’s analysis: “If we assume that screening reduces breast cancer mortality by 15% and that overdiagnosis and over-treatment is at 30%, it means that for every 2,000 women invited for screening throughout 10 years, one will avoid dying of breast cancer and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily.”

Let’s repeat the bottom line: Cochrane believes that medicine may be treating 10 otherwise healthy women unnecessarily due to over-diagnosis and over-treatment (most of these cases are DCIS; see previous blog). While it is fantastic one woman is save, what about the 10 women that receive needless treatments such as mastectomies?

In 2009, the U.S. Preventative Services Task Force reviewed the literature and decided to change the breast cancer screening guidelines to begin at 50 vs. 40 based on over-diagnosis, radiation exposure, and that (per one prominent study) no lives were being saved in the age group of 40-49 through screening.

Based on all of the aforementioned, and after researching the pros and cons of mammography on its own, the Swiss Medical Board (SMB) in 2016 put the kibosh on this breast cancer screening device upon which most women over the age of 40 depend worldwide. Specifically, the SMB no longer recommended doctors use mammography on women as the primary screening tool.

“In its report,” the Board stated, “[the SMB] advised against systematic screening…”, thus making mammograms optional for women pending any special circumstances. The SMB continued, “The existing systematic mammography screening programs are to be deferred.”

The New York Times reported that the Swiss Medical Board “…advised that no new mammography programs be started in that country and that those in existence have a limited, though unspecified, duration.”

Could a similar decision in the EU be far behind? Only time will tell. But France and other countries have pushed the start of breast cancer screening via mammography to age 50 up from 40 as well.

The SMB also opined that women should be informed of mammography’s vices, and that doctors should disseminate “…clearly understandable information describing the desirable and undesirable effects before they opt to receive mammography screening.”

We will discuss in a later blog that a prominent U.S. report in 1977 conducted by the American Cancer Society and the National Cancer Institute also recommended that women be given the detriments of mammograms before they undergo screening such as “the radiation output of the equipment used and its significance as a risk factor” — but that has yet to happen.

Blog at you soon, thanks for reading and helping to spread the word! (Please see the “share” links below).

Stay healthy,

Megan

Megan Smith, M.S.
Director, bOObs: The War on Women’s Breasts

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