“Giving the second-leading cancer killer in women a head start through reduced or delayed screening can be lethal for these women. Starting screening at age 40 remains the best policy,” added Dr. Wendy B. DeMartini, president of the Society of Breast Imaging (SBI).

Beyond that the ACR statement advised that “many breast cancer opinions stated in the Welch-Fisher perspective and the Lannin-Wang special report on overdiagnosis, survival and screening versus treatment effectiveness, are refuted by direct patient data in respected studies. These two papers published in the June 8 NEJM are based on assumptions, many of which are unsupported, rather than direct patient data, and should not affect breast cancer screening policy.”


It offered as a refutation of the claims that “breast cancer incidence rates did rise 1–1.3 percent per year prior to the start of widespread mammography screening in the mid/late 1980s. This fact negates their stated baseline for assessing overdiagnosis.”

Other studies, it continued, “show [that] women who get regular mammograms cut their breast cancer death risk nearly in half. Annual screening results in more lifesaving benefit than biennial screening for every age group.”

Moreover, “a study in the British Medical Journal based on direct patient data showed breast cancer overdiagnosis to be about 2 percent. This fits with American Cancer Society findings, which reconfirmed analyses by the American College of Radiology and the Society of Breast Imaging experts that high overdiagnosis claims (such as previously claimed by Welch) are inflated due to key methodological flaws in such studies.”

It estimated that overdiagnosis “likely” runs from one to ten percent. And this, it argued is “largely due to inclusion of ductal carcinoma in situ (DCIS).”

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