Letter: Value of Breast Cancer Screening
To the Editor:
I was a little dismayed and disconcerted to read yet another op-ed piece from Dr. H. Gilbert Welch (“Health Providers Haven’t Reckoned With Mammography’s Limits,” Feb. 23). Now, I have the utmost respect for Welch as a teacher and academician, having been a student of his at the The Dartmouth Institute, but he continues to be off base in recommending that women reassess the value of regular screening mammograms. Welch’s desire to decrease our utilization of a proven technology that has been established and effective for many years flies in the face of much of the international trials and meta-analysis evidence.
At present, there is no way to determine which breast cancers will reliably cause problems and which will not on a practical, clinical, day-to-day basis. So, we practicing physicians detect and remove them when found. I think the “distresses” caused by the inevitable, sporadic mammographic false positive are overstated by Welch; I believe the benefits of a silent cancer detected and cured far outweigh them.
Welch, despite his seemingly good intentions, does not address this aspect (biological aggressiveness) of breast cancer. If he did and was spot on, he would win the Nobel Prize for medicine.