Mammography screening for breast cancer—the UK Age trial – Authors' reply

2020 ◽  
Vol 21 (11) ◽  
pp. e510
Author(s):  
Stephen W Duffy ◽  
Peter D Sasieni
2020 ◽  
Vol 21 (11) ◽  
pp. e507
Author(s):  
Ritika Gera ◽  
Michael J Michell ◽  
Kefah Mokbel

2020 ◽  
Vol 21 (11) ◽  
pp. e504
Author(s):  
Katy J L Bell ◽  
Les Irwig ◽  
Brooke Nickel ◽  
Jolyn Hersch ◽  
Andrew Hayen ◽  
...  

2020 ◽  
Vol 21 (11) ◽  
pp. e509
Author(s):  
Alberto Donzelli ◽  
Giulia Giudicatti ◽  
Donatella Sghedoni

2017 ◽  
Author(s):  
Daniel Corcos

AbstractThe discrepancy between the protective effect of early surgery of breast cancer and the poor benefits of mammography screening programs in the long term can be explained if mammography induces breast cancer at a much higher rate than anticipated. Mammography screening is associated in most countries with a higher incidence of breast cancer, attributed to overdiagnosis. X-ray-induced cancers can be distinguished from overdiagnosed cancers by the fact that their incidence depends on the number of previous mammograms, whereas overdiagnosis solely depends on the last screening mammogram, leading to diagnosis. The unbiased relationship between the number of mammograms and breast cancer incidence was evaluated from the data of the NHS Breast Cancer screening programme in women aged from 50 to 64 years in the United Kingdom. The delay between mammography and increased breast cancer incidence was confirmed from the data of the “Age” trial, a randomized trial of annual screening starting at age 40 in the UK. In women aged 50-64 attending screening at the NHS Breast Cancer programme, in situ breast cancer incidence increased linearly from 1993 to 2005 as a function of the number of mammograms. Incidence did not increase anymore after 2005 when the number of mammograms and the delay after screening was stable. Invasive breast cancer incidence increased more specifically in the 60-69 age group. The risk of breast cancer almost doubled after 15 years of screening. Additional cancers began to occur less than 6 years after mammography. These results are evidence that X-ray-induced carcinogenesis, rather than overdiagnosis, is the cause of the increase in breast cancer incidence.


2018 ◽  
Vol 38 (1_suppl) ◽  
pp. 140S-150S ◽  
Author(s):  
Jeroen J. van den Broek ◽  
Nicolien T. van Ravesteyn ◽  
Jeanne S. Mandelblatt ◽  
Hui Huang ◽  
Mehmet Ali Ergun ◽  
...  

Background. The UK Age trial compared annual mammography screening of women ages 40 to 49 years with no screening and found a statistically significant breast cancer mortality reduction at the 10-year follow-up but not at the 17-year follow-up. The objective of this study was to compare the observed Age trial results with the Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer model predicted results. Methods. Five established CISNET breast cancer models used data on population demographics, screening attendance, and mammography performance from the Age trial together with extant natural history parameters to project breast cancer incidence and mortality in the control and intervention arm of the trial. Results. The models closely reproduced the effect of annual screening from ages 40 to 49 years on breast cancer incidence. Restricted to breast cancer deaths originating from cancers diagnosed during the intervention phase, the models estimated an average 15% (range across models, 13% to 17%) breast cancer mortality reduction at the 10-year follow-up compared with 25% (95% CI, 3% to 42%) observed in the trial. At the 17-year follow-up, the models predicted 13% (range, 10% to 17%) reduction in breast cancer mortality compared with the non-significant 12% (95% CI, -4% to 26%) in the trial. Conclusions. The models underestimated the effect of screening on breast cancer mortality at the 10-year follow-up. Overall, the models captured the observed long-term effect of screening from age 40 to 49 years on breast cancer incidence and mortality in the UK Age trial, suggesting that the model structures, input parameters, and assumptions about breast cancer natural history are reasonable for estimating the impact of screening on mortality in this age group.


Somatechnics ◽  
2013 ◽  
Vol 3 (1) ◽  
pp. 9-30
Author(s):  
Fiona K. O'Neill

In the UK, when one is suspected of having breast cancer there is usually a rapid transition from being diagnosed, to being told you require treatment, to this being effected. Hence, there is a sense of an abrupt transition from ‘normal’ embodiment through somatechnic engagement; from normality, to failure and otherness. The return journey to ‘embodied normality’, if indeed there can be one, is the focus of this paper; specifically the durée and trajectory of such normalisation. I offer a personal narrative from encountering these ‘normalising interventions’, supported by the narratives of other ‘breast cancer survivors’. Indeed, I havechosento become acquainted with my altered/novel embodiment, rather than the symmetrisation of prosthetication, to ‘wear my scars’,and thus subvert the trajectory of mastectomy. I broach and brook various encounters with failure by having, being and doing a body otherwise; exploring, mastering and re-capacitating my embodiment, finding the virtuosity of failure and subversion. To challenge the durée of ‘normalisation’ I have engaged in somatic movement practices which allow actual capacities of embodiment to be realised; thorough kinaesthetic praxis and expression. This paper asks is it soma, psyche or techné that has failed me, or have I failed them? What mimetic chimera ‘should’ I become? What choices do we have in the face of failure? What subversions can be allowed? How subtle must one be? What referent shall I choose? What might one assimilate? Will mimesis get me in the end? What capacities can one find? How shall I belong? Where / wear is my fidelity? The hope here is to address the intra-personal phenomenological character and the inter-corporeal socio-ethico-political aspects that this body of failure engenders, as one amongst many.


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