Early detection still crucial
Toolbox
Published: November 24, 2009
The recent U.S. government task force recommendations for screening mammography caught my attention. I have been involved with breast cancer care for the last 15 years and was looking for new guidelines to improve early detection and increase awareness of breast cancer. What I found was the opposite.
Simply summarized, the task force's recommendations are telling women that mammograms and breast self-exams are of little benefit to women under the age of 50 and may be harmful. They support their stand by pointing out that breast cancers grow slowly, and even larger lesions not picked up early can still be treated with aggressive surgical and medical management.
Yes, it is true that mammograms in younger women (because of increased breast density) are difficult to interpret and breast self- exams are not very accurate. However, these screening tools bring attention to subtle abnormalities, i.e. microcalcifications which can be associated with early cancers, that can be further worked up by a medical breast exam and imaging through ultrasound and MRI.
According to the American College of Radiology only 8 percent of people screened need a biopsy.
It is also true that surgical and oncological treatment has improved survival even for larger lesions. But who would want to wait? Detecting smaller lesions leads to better cosmetic results, less lymph node sampling, and possibly no chemotherapy.
Successful breast cancer treatment is about early detection and awareness. Mammograms, breast self-exams, and medical evaluation, in combination, increase the chance of discovering smaller breast cancers at earlier stages, which simplifies treatment. Women should ignore these new recommendations and continue with their yearly mammography, medical exams and monthly self-exams. Hopefully, the third party payers will also ignore these recommendations and continue to provide coverage.
GEORGE
KOPIDAKIS, M.D.
(Medical director,
Breast Care Center,
Springfield Hospital)
Springfield
20