TIPS: MAMMO’S OR NOT? THE CURRENT CONTROVERSY
Jean Criss
Recently I attended the CME Breast Cancer Management Conference on May 16, 2017 and received the following tips reported by Dr. Lauren C. Friedlander, Breast Surgeon, Columbia University. The current controversy women contend with is whether or not to have a mammogram and at what age to start. Perhaps some of these guidelines will help with your decision making. We know to keep calm because Pink is the new Black.
Here are some Basic Principles to know for Prevention, Good Screening and Testing
Screening for High Risk vs Average Risk
Patients with high risk due to genetic mutations or other factors must be addressed separately, as their pretest probability of having Breast Cancer is far higher than the average risk woman
Screening recommendations for specific high risk populations generally include mammography and breast MRI
It is estimated that 252,710 new cases of Breast Cancer will occur in 2017
40,610 deaths from Breast Cancer are estimated in 2017 (this is a 38% decline in mortality from 1990 – 2014 due to improved screenings and treatment)
12.4% of women will be diagnosed with Breast Cancer in their lifetime (the 1 in 8 factor)
The following organizations suggest these guidelines for Breast Cancer screening and mammography
USPSTF (US Preventative Service Task Force) suggests Women 50-74 every 2 years, Women in their 40’s is an individual discussion, and over 75 – there is not enough data
ACS (American Cancer Society) guidelines are different and suggest Women 45 – 54 be screened annually, 55 and older bi-annually (every 2 years), and 40 – 44 years of age is an individual choice
ASBCS (American Society of Breast Cancer Surgeons) suggests Women 40 – 44 individual discussion, 45 – 54 annual mammography, and over 55 is either annual or bi-annual, an individual choice
ACOG (American Congress of Obstetricians & Gynecologists) suggests it is an individual discussion
CR&SBI (College of Radiation & Society of Breast Imaging) suggests annual mammography to start at age 40 as long as a Woman is healthy
So if we have not confused you yet, what does this mean and what does everyone agree upon? The general consensus is as follows;
Screening for mammography saves LIVES! On average Women between ages 39 – 69
Screening is recommended in some form by all groups for Women aged 50 – 74
Screening mammography is imperfect
There are limitations and harms (anxiety, false-positive screening mammograms, radiation, results, costs and other factors)
Maximum benefit exists is 65% mortality reduction
Patients should make informed decisions
Dr. Friedlander’s final thoughts she shared were this;
It all comes down to how you weight the benefits versus the harms, a largely subjective endeavor
Counseling an individual patient differs from devising an effective population based screening algorithm
Changes in screening technology (tomosynthesis, ultrasound, MRI) as well as in the health care system will inform future guidelines
“Tailored screening” is where we’re headed
There are many worldwide RCS (Randomized Controlled Screenings) taking place to advance Breast Cancer research and improvement overall for patients. To participate in CTs (Clinical Trials), feel free to contact your local physician and the Columbia University Breast Cancer Management Department of Surgeons for further information about current clinical trials in your area.
Don’t let CANCER get the BREAST of you!
To shop for post-surgical undergarments, preview the collection here by author and designer Jean Criss. For media inquiries, contact me at jean@crisscrossintimates.com.
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