text_1: The trouble with mammograms
text_2: The idea that screening may be harmful is not often discussed in news stories. The story nicely presents this seemingly counter-intuitive point that finding more cancer may not save lives; however, the story could have discussed the role patients can play in deciding whether or not to get screened and how they could discuss this decision with physicians, who may be strong advocates for screening. The story does not mention that women could discuss an individualized screening schedule with their physician. Some women at higher-risk of breast cancer may be better candidates for annual screening between age 40-50 (or earlier, depending on family history or genetic markers), while others may not wish to screen until they are in their 50s or 60s. The story does not mention how physicians could counsel anxious patients on the true value of screening for breast cancer. The story does note that mass screening results in overtreatment and possibly unnecessary treatment for some women; however, the cost implications for such treatments are not discussed, an important omission at this time in the development of U.S. healthcare policy and physician reimbursements for screening. The story superbly cites expert epidemiologists and clinicians who discuss the problems with overselling mammograms and how this flies in the face of public health campaigns and U.S. clinical guidelines that women over 40 get annual mammograms. The story also cites a breast cancer survivor and advocate who questions the value of screening for some women. An advocate from a pro-screening group is also cited and her message is balanced by a clinician (who consults with the organization) who gives a tempered response to the latest data that screening may not benefit, and may even harm, women who are not at high-risk of developing aggressive breast cancer.