The design and implementation of new age Medical Imaging equipment, such as low-dose mammography scanners, have worked to provide improved diagnostic tools and better patient outcomes and experiences.
Recently, the Canadian National Breast Screening Study released findings on a 25-year old randomized trial on more than 89,000 women. The participants were divided into control groups, with half receiving annual mammograms and the other receiving none at all. The researchers’ results concluded that “annual mammography in women aged 40-50 does not reduce mortality from breast cancer.” Following the study’s publishing in the British Medical Journal, multiple organizations spoke out against the CNBSS study.
Response from ACR and SBI
Shortly after the results of the follow-up were released, the American College of Radiology and Society of Breast Imaging denounced the study, claiming it was full of misleading analysis and that it should not be used to alter or create new policies regarding breast screening. The organizations fear that doing so would place many women at increased risk of dying as a result of breast cancer.
According to the National Cancer Institute, mammograms help reduce the number of deaths from breast cancer for women between the ages of 40 and 70. The group advises that women 40 and older should have screenings done every year to monitor the possible development of cancer. These guidelines from the NCI thoroughly counter the claims from the CNBSS, calling into question the validity of the researchers’ findings.
Why they are flawed
In a guest post on Diagnostic Imaging, Ken Keller, M.D., discussed the numerous shortcomings of the CNBSS study and why it has no credence in mammography screenings. Serving as the medical director of the Department of Radiology at Trinity Health in Minot, N.D., Keller pointed out several components that render the study useless.
Firstly, the initial study was conducted and released more than 20 years ago using second-rate mammography equipment. By today’s digital imaging standards, the machinery would not be state-of-the-art and as a result, the scans would be less than substantial for adequate screenings.
Second, the radiologists involved in the study were not properly instructed on positioning techniques for mammograms. Current imaging specialists are certified in mammography training and most programs involve nearly six months of interpretation practice to ensure diagnosis accuracy.
Finally, Keller claimed that the participants were not sufficiently randomized for the trial. They received physical exams first, which tainted the study because women with palpable lumps could be “randomly” placed in the mammography group and alter the number of instances of breast cancer.
No changes yet
While little time has passed since the release of the CNBSS study, there is no indication that the NCI or ACR will change their breast screening recommendations. These groups’ standards on imaging have been in place for years after extensive research and have been proven to save lives. Although the research is compelling, it does not look as if health care will adopt the study’s findings into its diagnostic imaging regulations.
Ronny Bachrach
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