The recent New England Journal of Medicine paper titled “Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence” look at thirty-two years of cancer statistics in the U.S. and comes to the startling conclusion that roughly 1.3 million women have been overdiagnosed with breast cancer. In our newest “Foundation Perspectives” video, Dr. Mary McNaughton-Collins, medical director at the Informed Medical Decisions Foundation and a primary care doctor, gives us her take on the importance of this study. She provides a brief overview of the authors’ findings, explains why the overdiagnosis of breast cancer is harmful and provides her view on how these findings will affect how she engages women in a shared decision making conversation about screening mammograms.
Others, however, defended the researchers' conclusions, saying the study verifies research data that's been published in other countries. "They just took a different way of looking at the likely benefits of mammographic screening and the overdiagnosis rate," said Dr. Michael Barry, president of the Informed Medical Decisions Foundation.
To better gauge the extent to which patients are involved in decision making about 10 common medical issues, Floyd J. Fowler, PhD, and colleagues at the Informed Medical Decisions Foundation in Boston surveyed about 3000 patients. Patients were asked about the discussions they had with their physicians about 10 common medical decisions (whether to take medication for high blood pressure, high cholesterol, or depression; whether to be screened for breast, prostate, or colon cancer; or whether to undergo knee or hip replacement for osteoarthritis or surgery for cataracts or low back pain).
The overall purpose of this research is to contribute to improving communication with the community about screening mammography. The research involves developing and evaluating educational materials and strategies to meet the important ethical objective of providing balanced information about screening outcomes in order to support screening decisions.