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What is likely to happen if 10,000 women under age 50 have a mammogram?
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If 10,000 women have a mammogram, 640 women will have an abnormal mammogram and an average of 2 extra diagnostic tests will be done for each of these women.
One hundred and fifty of these women will have a surgical biopsy. Of the 640 women with an abnormal mammogram, 17 will turn out to have invasive breast cancer and, at best, mammograms may prevent one breast cancer death. More deaths from breast cancer are not prevented because most breast cancer detected by mammograms are not fatal breast cancers.
The time, worry and discomfort of the 623 women who must have extra tests, even though they don't have
breast cancer, may be acceptable to some women even though, at best, mammograms may help save one life of the 17 who turn out to have breast cancer.
*These numbers are based on the best available data and are a conservative estimate of the number of abnormal examinations, diagnostic tests and surgical biopsies performed and lives saved.
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References:
Salzmann P, Kerlikowske K, Phillips K. Cost-effectiveness of extending screening mammography programs to include women 40-49 years old. J General Intern Med 1997;12:63.
Kerlikowske K, Barclay J. Outcomes of modern screening mammography. Mongraph Natl Cancer Inst 1997;22:105-111.
Elmore JG, Barton MB, Moceri VM, Fletcher SW. Cumulative risk of a false-positive mammogram over a 10-year period. J General Intern Med 1997;12:107.
Kerlikowske K, Grady D, Barclay J, Sickles EA, Eaton A, Ernster V. Positive predictive value of screening mammography by age and family history of breast cancer. JAMA 1993;270:2444-2450.
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