Screening for Breast Cancer
October 04, 2010
A study shows that mammograms can reduce the risk of death by breast cancer by 26 percent for women in their 40s. Published online for the journal Cancer in June 2010, the study compared breast cancer deaths in women who had a diagnosis in counties in Sweden that offered mammograms, to deaths of patients in counties that offered no screenings.
The new study took advantage of circumstances in Sweden, where since 1986 some counties have offered mammograms to women in their 40s and others have not, according to the lead author, Hakan Jonsson, professor of cancer epidemiology at Umea University in Sweden. – The New York Times reported
However, according to The New York Times these results differ from the 2009 report by the U.S. Preventive Services Task force.
Other experts disagree, saying that overdiagnosis was a big problem as well.
Another concern with diagnostic tests for breast cancer in general is the potential harm that radiation can have on the patient.
To prevent overexposure to radiation, doctors are being encouraged to take a look at the patient’s past exposure, and determine the risk factor in an additional dose of radiation or if another diagnostic approach should be taken instead. One study published in the journal Radiology found that some nuclear-based imaging exams inject radioactive material, exposing patients to much higher doses of radiation than a traditional mammography. This increases cancer risk in organs like the kidney, bladder, or ovaries.
Over all, the United States population’s annual radiation dose from medical procedures increased sevenfold between 1980 and 2006, a second paper reports.
“I’m a radiation phobe — I’ll come right out and say this,” said Dr. Rhodes, an internist at the Mayo Clinic who is doing research to develop screening technologies that require less radiation exposure to the patient. “I’m constantly monitoring radiation doses in my patients.” – The New York Times reported.
The nuclear technologies involved in breast cancer screening tests are meant to serve as alternatives to traditional mammography and ultrasound tests, not for “routine screening” according to The New York Times.
There is also a concern that use of the imaging technologies will become more widespread and casual. “B.S.G.I. and P.E.M. are great tools for problem solving, if you have a patient with an abnormal mammogram and you’re not really sure,” said Dr. Rhodes. “The problem is these tests are now being considered and even being used in some cases as screening tests, and this is not appropriate.”
“I’m not saying ‘Don’t do the test,’ I’m just saying ‘Don’t prescribe these tests willy-nilly like you would an ultrasound exam,’ ” Dr. Hendrick said.