The Curious Case of Breast Cancer Screening

mass breast cancer screening failed In the last couple weeks two very important pieces of news came out regarding breast cancer. First, the American Cancer Society changed their guidelines and other news suggest screening might working as well as we’d hoped.

The general consensus behind cancer screening is that doctors will be able to detect the disease earlier and, as a result, this will lead to more successful treatments; however, for breast cancer screening, that doesn’t seem to be the case.

According to an article (and chart) in The New England Journal of Medicine, the incidence of metastatic cancers (the more deadly cancers) has remained more or less stable since 1975. This is despite the introduction of widespread screening programs that aimed to get women of a certain age regular mammograms.

This seems counterintuitive, especially since the we’ve seen a completely different situation occur for prostate cancer. Since the initiation of widespread screening for prostate cancer we’ve seen – what appears to be – a clear reduction in the number of men with cancers that eventually spread.

Unfortunately, the data would suggest that widespread mammography programs aren’t really making much of a difference on the overall number of women who have serious breast cancers. This might mean mass screening is probably unable to detect the most aggressive forms of the disease at early stages.

What this means for you…

As usual, you should always listen to your doctor. Women with a family history of breast cancer fall into a completely different category, but for the rest of us,  the American Cancer Society now recommends women begin annual mammograms at age 45, with less frequent mammograms beginning at age 55.

The new guidelines from the American Cancer Society and recent news about screening are  difficult to process in terms of actions you should take. Women are now confronted with numerous different guidelines, each suggesting screening at different ages and no clear evidence of the effectiveness of regular screening altogether.

The big concern now is a lack of a clear direction for women and their doctors to take to help maintain our health. It is important to know, there is a difference in  mass screening from other technologies, like ultrasounds to diagnose individuals at risk. Also, the prostate-specific antigen test – accompanied by multiple biopsies — is far more sensitive than the mammogram, which is good news and bad news. Many men who would never die from the disease, are now get diagnosed. The questions is, if a similar organwide sampling strategy were used for breast cancer, would fewer women would present with metastatic breast cancer?

Source: Vox and The New England Journal of Medicine (and this one)

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