A New Approach To The Regularity Of Mammography

A New Approach To The Regularity Of Mammography.


A reborn circulate challenges the 2009 recommendation from the US Preventive Services Task Force that women between 40 and 49 who are not at serious risk of breast cancer can probably wait to get a mammogram until 50, and even then only require the exam every two years. A well-known Harvard Medical School radiologist, calligraphy in the July issue of Radiology, says telling women to wait until 50 is supine out wrong hydroxycut.herbalous.com. The task force recommendations, he says, are based on faulty expertise and should be revised or withdrawn.



So "We know from the scientific studies that screening saves a lot of lives, and it saves lives all women in their 40s," said Dr Daniel B Kopans, a professor of radiology at Harvard Medical School and superior radiologist in the breast imaging division at Massachusetts General Hospital in Boston learn more. The US Preventive Services Task Force (USPSTF) said its recommendation, which sparked a firestorm of controversy, was based in knowledge and would salvage many women each year from inessential worry and treatment.



But the guidelines left most women confused. The American Cancer Society continued to vouch for annual mammograms for women in their 40s, and young breast cancer survivors shared vigorous stories about how screening saved their lives. One main poser with the guidelines is that the USPSTF relied on incorrect methods of analyzing data from breast cancer studies.



The hazard of breast cancer starts rising gradually during the 40s, 50s and gets higher still during the 60s. But the figures used by the USPSTF lumped women between 40 and 49 into one group, and women between 50 and 59 in another group, and adamant those in the younger group were much less likely to develop chest cancer than those in the older group.



That may be true except that assigning age 50 as the "right" discretion for mammography is arbitrary. "A woman who is 49 is similar biologically to a woman who is 51. Breast cancer doesn't keep track of your age. There is nothing that changes abruptly at age 50".



Other problems with the USPSTF guidelines comprise the following. The guidelines cite research that shows mammograms are to blame for a 15 percent reduction in mortality. That's an underestimate. Other studies show screening women in their 40s can knock down deaths by as much as 44 percent. Sparing women from unnecessary irritation over false positives is a poor reason for not screening, since dying of breast cancer is a far worse fate. "They made the biased decision that women in their 40s couldn't tolerate the anxiety of being called back because of a arguable screening study, even though when you ask women who've been through it, most are pleased there was nothing wrong, and studies show they will come back for their next screening even more religiously. The piece of work force took the decision away from women. It's incredibly paternalistic". The effort force recommendation to screen only high-risk women in their 40s will avoid the 75 percent of breast cancers that occur among women who would not be considered high risk, that is, they don't have a doctrinaire family history of the disease and they don't have the BRCA1 or BRCA2 genes known to intensify cancer risk.



Since the furor over the guidelines, the USPSTF has backed off some of the original wording, amending tongue to make it clearer that the decision to have a mammogram between 40 and 49 is an "individual one," said Dr Ned Calonge, USPSTF bench and chief medical officer of the Colorado Department of Public Health. Calonge is co-author of an opinion piece in the same issue of Radiology. "It was a bad communication to a lay audience. The task force recommends against automatic screening. We consider the knowledge of what can be gained versus what is risked is an important discussion to have with women in that age group".



The drawbacks take in unnecessary additional testing, biopsies, treatment that will provide no health good and, yes, anxiety. As for the benefits, mammography can save lives, but perhaps not as many as women may believe. Studies show that for every 1000 40-year-old women vigorous today, 30 would eventually crave of breast cancer.



Beginning mammography at age 50 and continuing it biennially to age 74 can break those deaths by seven. Or, in other words, 23 will still die of breast cancer despite screening. Beginning mammography at grow old 40 can reduce deaths by one more, to 22.



"It's clear mammogram is a practical tool in the fight against breast cancer and that the appropriate use of mammogram will prevent some deaths. But the probe is far from perfect, the benefits are smaller than many people assume, and women should know there are drawbacks".



Both Kopans and Calonge come that complicating all analyses is the fact that early detection of breast cancer doesn't as a result translate into prolonging life. Breast cancer tumors can be highly aggressive, and even beforehand detection won't mean a longer life. On the other hand, some tumors are extremely dead growing and might never cause a problem even if left untreated.



The problem is, doctors don't know which tumor is which, Kopans stated. "It's stable that mammography is far from perfect. But it's the only check for breast cancer we have that has been shown to save lives. In the United States, we've seen a 30 percent lessening in the breast cancer death rate since the beginning of mammography screening in the mid-1980s". In theory, the concept of discussing mammography with your cure is a good one. But with primary care appointments typically durable under 10 minutes, doctors are not going to discuss randomized clinical trials with you here. Instead, they will rely on guidelines such as the USPSTF report.

tag : women cancer breast screening mammography uspstf force guidelines lives

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