over the value of breast X-rays to women under 50, a Royal Gazette survey revealed.

Yesterday, researchers at the University of California in San Francisco fuelled a long-standing medical controversy when they announced their conclusion that mammography has little benefit for women under 50.

The researchers based their finding on a review of 13 breast cancer studies between 1966 and 1993 and construed that mammography reduces breast cancer mortality by 26 percent in women aged 50 to 74 but does not significantly reduce mortality rates in those aged 40 to 49.

"These findings suggest that it might be possible to wait to begin screening until women become 50 or menopausal and achieve the same benefit in mortality reduction as beginning screening at 40 years of age,'' the researchers said.

A second study by the Rand Corporation of California also suggested that mammography screening be limited to women aged 50 to 69.

But the American Medical Association, in whose weekly journal the reseachers' finding was published, disagreed with the conclusion and said it still recommends mammographies every one to two years for women between the ages of 40 and 50.

Dr. James Allen, an AMA vice-president, said such studies "should not be used alone as the basis for denying screening mammograms to women'' aged 40 to 49.

Meanwhile, a survey of the Island's mammography facilities showed the same division of opinion among those who oversee the procedure, with the radiology department of King Edward VII Memorial Hospital agreeing with the researchers and the Bermuda TB, Cancer and Health Association siding with the AMA.

"(Patients) are welcomed at 35, although we won't see them again until they're 40,'' said Mrs. Elaine Harrington of the TB, Cancer and Health Association.

"If there is nothing on their X-ray and there is no family history of cancer, we will usually see them every two years after that.'' On the other hand, hospital radiologist Dr. Ian Harvey said he personally saw little need for asymptomatic women under 50 to undergo the procedure and almost no need at all for those under 40 to be X-rayed.

"I would agree that it (mammography) is of little benefit (to women under 50),'' he said. "But it's debatable. We tend to examine women over 50 every year and women between 40 and 50 every other year.'' Although both Dr. Harvey and Mrs. Harrington agreed that the breasts of younger women were too dense to X-ray conclusively, they also stressed that their respective facilities had no rules on the practice and generally followed the recommendations of individual doctors.

As a general practitioner, meanwhile, Dr. Ewart Brown of Bermuda Health Care Services Ltd. said he remained wary of large-scale studies that took a largely statistical approach and were motivated in the US by a need to ration health care.

"What (the studies) really conclude is that statistically it (mammography for women under 50) doesn't make sense,'' he said.

"But until it is shown that mammography is of no benefit, screening is in order.'' Dr. Brown said that women over 50 should have mammograms annually, those between 40 and 50 every second year and those aged 35 to 40 only if cancer is indicated.

Between 1983 and 1993, a total of 328 women were diagnosed in Bermuda with breast cancer. Of those, 99 have died.