Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started
My Medicine

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Breast Cancer Health Center

Font Size

Breast Cancer Screening (PDQ®): Screening - Health Professional Information [NCI] - Appendix of Randomized Controlled Trials


Malmo, Sweden 1976[3,4]

Age at entry: 45 to 69 years.
Randomization: Individual, within each birth year cohort for the first phase, MMG screening trial (MMST I). Individual for the entire birth cohort 1933 to 1945 for MMST II, but with variations imposed by limited resources. Validation by analysis of age in both groups shows no significant difference.
Exclusions: In a Swedish meta-analysis, there were 393 women with pre-existing breast cancer excluded from the intervention group, and 412 from the control group. Overall however, there were 86 more women excluded from the intervention group than from the control group.
Sample size: 21,088 study and 21,195 control.
Consistency of reports: No variation in patient numbers.
Intervention: Two-view MMG every 18 to 24 months × 5.
Control: Usual care, with MMG at study end.
Compliance: Participants migrating from Malmo (2% per year) were not followed. The participation rate of study women was 74% for the first round and 70% for subsequent rounds.
Contamination: 24% of all control women had at least one MMG, as did 35% of the control women aged 45 to 49 years.
Cause of death attribution: 76% autopsy rate in early report, lower rate later. Cause of death assessment blinded for women with a breast cancer diagnosis. Linked to Swedish Cause of Death Registry.
Analysis: Evaluation, initially. Follow-up analysis, as part of the Swedish meta-analysis.[5]
External audit: No.
Follow-up duration: 12 years.
Relative risk of breast cancer death, screening versus control (95% CI): 0.81 (0.62-1.07).
Comments: Evaluation analysis required a correction factor for the delay in the performance of MMG in the control group. The two Malmo trials MMST I and MMST II have been combined for most analyses.

Ostergotland (County E of Two-County Trial), Sweden 1977[6,7,8]

Age at entry: 40 to 74 years.
Randomization: Geographic cluster, with stratification for residence (urban or rural), socioeconomic factors and size. Baseline breast cancer incidence and mortality were comparable between the randomly assigned geographic clusters. The study women were older than the control women, P < .0001, but this should not have had a major effect on the outcome of the trial.
Exclusions: Women with pre-existing breast cancer were excluded from both groups, but the numbers are reported differently in different publications. The Swedish meta-analysis excluded all women with a prior breast cancer diagnosis, regardless of group assignment.
Sample size: Variably reported, ranging from 38,405 to 39,034 in study and from 37,145 to 37,936 in control.
Consistency of reports: Variable.
Intervention: Three single-view MMGs every 2 years for women younger than 50 years and every 33 months for women 50 years and older.
Control: Usual care, with MMG at study end.
Compliance: 89% screened.
Contamination: 13% of women in the Two-County trial had MMG as part of routine care, mostly in 1983 and 1984.
Cause of death attribution: Determined by a team of local physicians. When results were recalculated in the Swedish meta-analysis, using data from the Swedish Cause of Death Registry, there was less benefit for screening than had been previously reported.
Analysis: Evaluation initially, with correction for delay in control group MMG. Follow-up analysis, as part of the Swedish meta-analysis.[5]
External audit: No. However, breast cancer cases and deaths were adjudicated by a Swedish panel that included the trial's investigators.[9]
Follow-up duration: 12 years.
Relative risk of breast cancer death, screening versus control (95% CI): 0.82 (0.64-1.05) Ostergotland.
Comments: Concerns were raised about the randomization methodology and the evaluation analysis, which required a correction for late performance of the control group MMG. The Swedish meta-analysis resolved these questions appropriately.
1 | 2 | 3 | 4 | 5 | 6
Next Article:

Today on WebMD

Breast Cancer Overview
From self-exams and biopsies to reconstruction, we’ve got you covered.
Dealing with breast cancer
Get answers to your questions.
woman having mammogram
Experts don’t agree on all fronts, but you can be your own advocate.
woman undergoing breast cancer test
Many women worry. But the truth? Most abnormalities aren’t breast cancer.
Breast Cancer Treatments Improving
Resolved To Quit Smoking
Woman getting mammogram
Screening Tests for Women
ovarian cancer overview slideshow
serious woman
what is your cancer risk
10 Ways to Revitalize Slideshow