Breast Calcifications Scrutinized

Some doctors are questioning the need for early intervention. They say treatments can have potentially deadly side effects and note a recent study that raised the issue of whether some early-stage cancers might actually regress if left alone.

Published in November in the Archives of Internal Medicine, the study found women who had more frequent mammograms -- three in six years versus one in six years -- had a 22 percent higher incidence of invasive breast cancer.

The results seemed counterintuitive, especially in Western society, where early detection has been the cautionary drumbeat for years. The Norwegian researchers said other factors could account for part of the increased incidence of cancer in more frequently screened women -- those women were more likely to use hormone replacement therapy, for instance -- but those factors alone couldn't explain the difference in cancer diagnoses between the two groups of women.

For some doctors, the study raises the question: Might many instances of breast cancer go away if left alone? And how much harm is caused by treating women early with medications that can weaken their immune systems, cause surgical burns and expose them to radiation?

"What is important, and it seems to me it's been ignored for a long, long time, is that ... screening doesn't only have upsides. It has downsides," Cornelia J. Baines, professor emeritus at the University of Toronto Dalla Lana School of Public Health and co-principal investigator of the Canadian National Breast Screening Study, told The Canadian Press newspaper.

One recent study shows that for every life saved, 10 healthy women will be treated unnecessarily for cancer, says Dr. Michael Baum, a surgeon and visiting professor at University College London. He said in an e-mail that declining mortality rates are more likely linked to better treatments, such as the adoption of tamoxifen and improved chemotherapy.

Statistically there is evidence that some women who have part or all of their breast removed would never have advanced to a more aggressive stage of cancer, Winer says.

The problem is that, at this point, there is no way to distinguish which cases of DCIS will become aggressive from those that probably would never hurt a woman during her lifetime, he says.