Overdiagnosis claims not supported, ACR, SBI say

A new paper in the Annals of Internal Medicine claiming overdiagnosis in breast screening has findings that are not supported by data, according to the American College of Radiology (ACR) and the Society of Breast Imaging (SBI).

The January 10 paper by Jørgensen et al is not based on direct patient data showing which women had mammograms and which did not, the societies said. The authors claims that as many as 48% of tumors detected in women are actually overdiagnosis are vastly inflated due to key methodological flaws, they added.

"Breast cancer overdiagnosis is likely 1% to 10% -- largely due to inclusion of ductal carcinoma in situ (DCIS)," ACR and SBI wrote in a statement. "These are noninvasive cancers often treated to avoid development of 'invasive' cancers. There is no medical evidence that invasive cancers are overdiagnosed. There is little evidence that invasive cancers often go away or shrink without treatment. Medical science cannot determine which cancers will or will not advance. Most doctors understandably recommend treatment."

In addition, the small amount of overdiagnosis that does occur will not be decreased by delayed or less-frequent screening, the societies said. The ACR and SBI will continue to recommend that women start undergoing annual mammograms at age 40 and keep doing so as long as they are in good health.

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