• Mammogram screening and overdiagnosis: tumor size an issue?

    Hologic Imaging MachineDOTmed.com – Health Care Business Daily News
    Written by: Thomas Dworetzky , Contributing Reporter

    A just-published study of breast cancer data has raised the issue of overdiagnosis from mammography screening – and puts tumor size squarely in the middle of the debate.

    That’s because many “small breast cancers have an excellent prognosis because they are inherently slow-growing,” according to Yale Cancer Center experts in a June 8th New England Journal of Medicine report, which weighed in on the benefits of breast cancer early detection.

    Frequently these smaller tumors come from slow-growing cancers that may not become an issue during a patient’s lifetime, they noted. [Read More…]

  • Abolishing Mammography Screening Programs? A View from the Swiss Medical Board

    Nikola Biller-Andorno, M.D., Ph.D., and Peter Jüni, M.D.

    April 16, 2014DOI: 10.1056/NEJMp1401875

    In January 2013, the Swiss Medical Board, an independent health technology assessment initiative under the auspices of the Conference of Health Ministers of the Swiss Cantons, the Swiss Medical Association, and the Swiss Academy of Medical Sciences, was mandated to prepare a review of mammography screening. The two of us, a medical ethicist and a clinical epidemiologist, were members of the expert panel that appraised the evidence and its implications. The other members were a clinical pharmacologist, an oncologic surgeon, a nurse scientist, a lawyer, and a health economist. As we embarked on the project, we were aware of the controversies that have surrounded mammography screening for the past 10 to 15 years. When we reviewed the available evidence and contemplated its implications in detail, however, we became increasingly concerned.

    First, we noticed that the ongoing debate was based on a series of reanalyses of the same, predominantly outdated trials. The first trial started more than 50 years ago in New York City and the last trial in 1991 in the United Kingdom. None of these trials were initiated in the era of modern breast-cancer treatment, which has dramatically improved the prognosis of women with breast cancer. Could the modest benefit of mammography screening in terms of breast-cancer mortality that was shown in trials initiated between 1963 and 1991 still be detected in a trial conducted today? [Read More…]

  • Are the Harms of Mammography Underestimated?

    April 08, 2014

    By Kristen Fischer

    More controversy has emerged surrounding mammograms ever since a new report in JAMA recommended that the test be performed based on a woman’s risk and preferences.
    Dr. Lydia Pace and Dr. Nancy Keating both of Brigham and Women’s Hospital in Boston, conducted a systematic review of data spanning 50 years. They examined about 450 studies from 1960 through the present to look for evidence on the benefits and harms of the diagnostic test.

    According to their report, annual mammograms lower mortality from breast cancer by about 19 percent, though the benefits vary based on a woman’s risk and age. Approximately 1,904 women in their 40s would have to undergo a mammogram to prevent one death, while the same would be true for 377 women in their 60s. The disease is more common as a woman ages. At 40, the risk for breast cancer in the next 10 years is 1.5 percent, but that rises to 2.3 percent by age 50, and 3.5 percent by age 60. [Read More…]

  • Barred From Breast Screening

    Under 50 … Younger women are missing out on breast screens. Source: The Sunday Telegraph

    ALMOST a quarter of breast cancers diagnosed in Australia occur in females under 50, so why is the Government recommending screening for older women only?

    Sitting in a drawer of a Canberra office is a report recommending significant changes to Australia’s breast-screening program.

    It’s been there since last June. It says the government should lower its target age range for routine mammograms from 50 to 45, and extend it at the other end of the age range, from 69 to 75.

    Such changes would have done little to help the likes of the late Jane McGrath. The wife of former fast bowler Glenn was only 31 when she was diagnosed with breast cancer. She died in 2008. [Read More…]

  • Cruel Wait Not Breast Practice

    • Robyn Riley
    • From: Sunday Herald Sun
    • April 11, 2010 12:00AM
    • 18 comments

    I AM no doctor, but as someone who was a medical writer for many years, I consider myself reasonably well informed on medical matters.

    But I did not know that BreastScreen Australia provided a screening mammogram only – not a diagnostic mammogram.

    There is a big difference, as I found out last week.

    A screening mammogram is only for women who do not present with symptoms. So the first thing to remember is that anyone with symptoms – and that can be anything from a lump to a discharge or even changes in colour – should not use the free BreastScreen program.

    They should have a GP refer them for a diagnostic mammogram.

    Why? Because it can save you several weeks of worrying. A diagnostic mammogram is also more specific and the results can be returned within a day. [Read More…]

  • Christine O’Gorman Suffers Misdiagnosis at BreastScreen

    Cruel treatment … Cancer sufferer Chrsitine O’Gorman with her partner, Glen Fitzpatrick. Picture: Stephen Cooper Source: The Daily Telegraph

    CHRISTINE O’Gorman was lying in bed reading when she scratched an itch in her left breast and felt a lump “as hard as concrete”.

    For the 57-year-old single mum, the subsequent diagnosis last year of a cancerous tumour was at odds with every mammogram result she had ever received – and she had been diligently having her breasts screened every two years since 1994.

    Like thousands of women aged between 50 and 69, O’Gorman visited a government-funded BreastScreen clinic to have her mammograms. It was convenient, free of charge and she was able to fit a visit in during her lunch hour.

    To her immense relief, after every mammogram examination O’Gorman received a letter from BreastScreen stating “there was no visible evidence of breast cancer”.

    Shockingly, it now emerges that there was visible evidence. Those reassuring letters from BreastScreen turn out not to be worth the paper they were written on. [Read More…]