Breast Cancer Overdiagnosis

Medscape Medical News > Oncology
Study: 1.3 Million Overdiagnosed Breast Cancers in 30 Years - Nick Mulcahy
http://www.medscape.com/viewarticle/774966?src=nldne


This article nicely summarizes a lot of controversy lately regarding breast cancer screening.   Long-term studies in Scandinavia and the States are causing quite a paradigm shift.  Key points include:

-' "overdiagnosed,"...means their screening-detected tumors would never have led to clinical symptoms'
-'the advent of widespread mammography screening in the United States led to a "substantial increase" in early-stage breast cancer, but only "marginally reduced" the rate of advanced cancers detected. "The imbalance suggests that there is substantial overdiagnosis." '
-'only 8 of the 122 [per 100,000 women] additional early-stage cancers diagnosed were expected to progress to advanced disease'
-'screening is having, at best, only a small effect on the rate of death from breast cancer'

The Canadian Task Force on Preventative Health Care (composed primarily of MDs) has made the following recommendations to health care professionals:

Mammography
For women aged 40–49 we recommend not routinely screening with mammography. (Weak recommendation; moderate quality evidence)
For women aged 50–69 years we recommend routinely screening with mammography every 2 to 3 years. (Weak recommendation; moderate quality evidence)
For women aged 70–74 we recommend routinely screening with mammography every 2 to 3 years. (Weak recommendation; low quality evidence)

Magnetic Resonance Imaging
We recommend not routinely screening with magnetic resonance imaging. (Weak recommendation; no evidence)

Clinical Breast Exam
We recommend not routinely performing clinical breast exam alone or in conjunction with mammography to screen for breast cancer. (Weak recommendation; low quality evidence)

Breast Self Exam
We recommend not advising women to routinely practice breast self exam. (Weak recommendation; moderate quality evidence)

Here is the link for the Patient FAQ document http://canadiantaskforce.ca/guidelines/2011-breast-cancer/breast-cancer-screening-patient-faq/

It takes time for information like this to be evaluated, absorbed and implemented; but don't be surprised if the recommendations you receive regarding breast cancer screening begin to change in the next few years.