Screening Mammography and Breast Cancer Reduction: Examining the Evidence

• Experts disagree on the benefits of screening mammograms for women not at high risk.
• Better treatment and greater awareness have led to a drop in breast cancer mortality.
• The biggest risk of screening mammography is overdiagnosis.
• Nurse practitioners should discuss research on screening with their patients.
• Watching weight and limiting alcohol and estrogen treatment help lower risks.

Better treatment and awareness may explain much of the decline in breast cancer deaths in recent years, not mammography. For women without a family history of breast cancer, the risks of screening mammography may outweigh the benefits, particularly for women younger than age 50. Mammography carries the risk of overdiagnosis of tumors that would not have caused death. Nurse practitioners are advised to educate their patients on mammography risks and benefits while increasing their emphasis on the clinical symptoms of breast cancer and ways to reduce risk, including weight control, decreased alcohol use, and decreased use of menopausal estrogen.