Breast Cancer Screening- Does Screen Save Lives?

In 2013 there will be nearly 250,000 new cases of breast cancer and 40,000 deaths from breast cancer. Now there is a move to decrease screening for this most common cancer in women. This blog will discuss the guidelines from the Task Force on Preventive Healthcare.

Summary of the task force guidelines. Women 50-69 years of age should have mammograms every 2-3 years instead of every year. Women under 50 should not have mammograms. Clinical examinations by a doctor and breast self-exams have no benefit. Routine screening with MRI scans is not recommended.

These guidelines do not apply to women at high risk. These are women with a family history of breast cancer. Also includes women who test positive for the BRCA gene 1 or 2.

Self-examination has been the suggestion for women for decades. Experts say it is not a good idea.

Screening for women is not the lifesaver it was once thought to be. The task force looked at 2100 women between 40 and 59 years of age would have to be screened every 2-3 years for an eleven year period to prevent one breast cancer death. This suggests a very small benefit over a very large number of screenings. The task force even pointed out that screenings more do more harm than good. Nearly 700 of the 2100 women would have had a false mammogram requiring further imaging. 75 of these 700 women would have a biopsy just to confirm that they do not have breast cancer and at least 10 women would have part or all of their breast removed. This does not include all the anxiety that surrounds a positive mammogram and the waiting and discomfort associated with the biopsy.

What’s my advice? Certainly if a woman is in the high-risk group, mammography and screening is imperative. Women should have a discussion with their doctor and make an informed decision and weight the risks vs. the benefits of screening. This is not a doctor only decision it is a doctor-patient decision. Patients who become informed and have a discussion with their doctor will be the ones that make the best decision. Finally, I am not agreement with the recommendation on the breast self-exam. I still believe this a low cost valuable test that can detect small lesion in the breast before they become clinically relevant.

My next blog will discuss the guidelines on prostate cancer screening.

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