New Breast Screening Information Is Confusing to Women

April 7th, 2007

This spring, new information came out about breast cancer screening, much of it perplexing to women. Past guidelines for annual mammograms included women in their 40s. Now, a major medical group disputes the need to screen women between the ages of 40 and 49.

The American College of Physicians has issued new and controversial guidelines. Their rationale is that for every 10,000 women screened in their 40s, perhaps six might avoid death from breast cancer. In addition, a high percentage of false positives could lead to unnecessary biopsies, increased costs, and potential for injury. Younger women receiving annual screenings might also incur a tiny risk of cancer developing from radiation used in mammograms.

All medical groups and experts agree that women 50 and over should get regular annual mammograms. Some women are known to have a very high risk of developing breast cancer — based on a strong family history or genetic testing showing defective BRCA1 and BRCA2 genes. The American Cancer Society recommends screening mammograms and MRI imaging for these women, beginning at age 30. Sonograms are also used for more definitive imaging in high-risk young women whose breasts are quite dense.

Recently, a new study found that MRI scans can detect tumors mammograms missed in about 3% of women. This sensitive technology, not available in all hospitals, often picks up suspicious but harmless growths that need to be biopsied. The result can be costly procedures that might cause unnecessary alarm in women. For those few in whom cancer is found at an early stage, MRI can prove valuable and, hopefully, life-saving.

Another controversial subject is a computer-assisted program designed to help radiologists identify small cancers on mammograms. This system has proved to be no more effective than traditional mammography read by an experienced radiologist. The technology also has led to many false alarms requiring needless biopsies. About 30% of mammography centers use computer-assisted technology, and no clear medical benefits have been found. Government and private insurers may be re-evaluating whether these expensive systems are worth the price.

The best advice in the screening controversy is to assess your risks carefully with your physician and determine what is right for you. If you are very high risk for breast cancer, use all available technologies at an early age. Early detection is still the best strategy.

Source:   New York Times

Entry Filed under: Breast Cancer,Breast Cancer,CANCER,WOMEN'S HEALTHCARE