Susan G. Komen Accused Of 'Overselling' Mammograms

Cancer survivors cheer on the runners at the start of the Susan G. Komen Race for the Cure Saturday April 21,2012 in Savannah
Cancer survivors cheer on the runners at the start of the Susan G. Komen Race for the Cure Saturday April 21,2012 in Savannah, Ga. (AP Photo/The Morning News, Richard Burkhart) THE EXAMINER.COM OUT; SFEXAMINER.COM OUT; WASHINGTONEXAMINER.COM OUT

Susan G. Komen For The Cure has misled women about the benefits of mammography, two Dartmouth professors charge in an op-ed published in the British Medical Journal.

Dr. Steven Woloshin and Dr. Lisa Schwartz, two researchers with the Dartmouth Institute for Health Policy and Clinical Practice, argue that the breast cancer charity has oversold the potential benefits of mammograms and underrepresented the possible risks. Their criticism was focused on a Komen advertising campaign from 2011.

"Early detection saves lives," read that advertisement, which ran as part of what the researchers call a national promotional "blitz" during breast cancer awareness month last October. "The 5-year survival rate for breast cancer when caught early is 98 percent. When it's not? 23 percent," the ad continued.

"At the time, you couldn't open up a women's magazine or newspaper without seeing this ad," Woloshin told The Huffington Post.

"It kind of drove us crazy, because it gives this survival statistic that's an optical illusion," he continued. "It seems to say that [mammography] has this huge effect, and you'd have to be really irresponsible or crazy to not be screened."

According to Woloshin, the problem is not that mammography screening is without real and potentially significant benefits. It is that the survival statistic used in the Komen ad is unreliable.

The authors write:

Imagine a group of 100 women who received diagnoses of breast cancer because they felt a breast lump at age 67, all of whom die at age 70. Five-year survival for this group is now 0 percent. Now imagine the women were screened, given their diagnosis three years earlier, at age 64, but still die at age 70. Five year survival is now 100 percent, even though no one lived a second longer.

Susan G. Komen, which recently came under fire after it cut funding for Planned Parenthood, released a statement in response to the article, saying that mammography, while not perfect, is the "best widely available detection tool that we have today."

"The numbers are not in question," Chandini Portteus, Komen's vice president of research, evaluation and scientific programs, said in the statement. "Early detection allows for early treatment, which gives women the best chance of surviving breast cancer."

Recommendations for screening mammograms -- X-rays taken of the breasts of women who do not have signs or symptoms of breast cancer -- vary.

The American Cancer Society recommends yearly mammograms for women starting at age 40, saying that "most doctors feel that early detection tests for breast cancer save thousands of lives each year." The National Cancer Institute also recommends women go in for mammograms once a year or once every two years beginning at age 40.

By contrast, the U.S. Preventive Services Task Force recommends biennial screening mammograms for women age 50 to 74, saying that the decision to start screening younger is an individual one that should be made between doctors and patients.

Woloshin and Schwartz also pointed to the National Breast Cancer Coalition, which believes there is too little evidence to recommend for or against routine mammograms in any age group of women.

Studies have associated several possible harms with mammograms, including false alarms and over-diagnosis that can lead to unnecessary chemotherapy, radiation or surgery.

"For every life saved by mammography, around two to 10 women are overdiagnosed," the BMJ op-ed states.

Still, Woloshin stressed that the goal of his article is not to deter women from getting screening mammograms for breast cancer, which is the second-most common cancer among women in the U.S. Instead, he said, it is to make Susan G. Komen reconsider its messaging before the upcoming breast cancer awareness month in October.

"A good ad would be one that makes it clear that this is a genuine choice," he said. "You need to know the facts, and you need to weigh them yourself," he said.