Sunday, 18 December 2011 15:11
Breast cancer remains the most deadly cancer affecting women all over the world.It is estimated that there are 1.4 million new cases diagnosed each year. And the trend seems to be increasing each year.In 2009, the U.S. Preventive Services Task Force (USPSTF) released a new set of guidelines for clinicians to follow in screening for breast cancer in women. In the said guidelines, breast self examination (BSE) is no longer recommended and women should decrease the frequency of their mammograms to every two years.These new rules have incited controversy among patients and physicians.
Melecia Agbayani, a retired employee says "This is a most welcome development. Since I have no health care insurance, I shoulder the expense of all my medical examinations.
In the past, I would delay my mammograms because I could not afford a yearly test. It is comforting to know that i am still protected even if I do the mammogram every 2 years."The American Cancer Society and American College of Radiology are a few of the organizations opposing these revised recommendations. These authorities are afraid that decreasing the frequency of mammograms to every two years might miss out on detecting new cancer growths.In the recently concluded Breast Cancer Symposium in September 2011 held in California, a large analysis presented the complete opposite of the USPSTF recommendations. The symposium stressed on the importance of yearly mammography and BSE in detecting cancer in women younger than 50 years old.One of the researches presented was composed of 6,000 women with breast cancer. In this group, 66% of cancers were detected by mammography, 30% by palpation and the remained by other methods.An important note for the patients whose masses were discovered by palpation: their tumors tend to be far more advanced compared to the cancers discovered by mammography.Dr. Jamie Caughran, the lead author of the study observed: "The women whose tumors were detected by palpation were more likely to undergo a mastectomy and chemotherapy compared to tumors found via mammography."Analyzing the information gathered from the opposing parties, Dr. Caughran may have inadvertently supported the USPSTF's stand on NOT recommended BSE to patients.If patients rely solely on BSE, they have the risk of discovering their tumors at a late stage of the disease where conservative management may no longer be an option. It seems prudent to agree with USPSTF to eliminate BSE as a screening tool for breast cancer. Only a mammogram can detect a tumor in its earliest stage.At the moment, no consensus has been reached by local societies as to how often a mammogram ought to be done.It should be safe follow these simple rules:1. Start screening mammography at 40 years old and above.2. If you have a first-degree relative with breast cancer, repeat the mammogram every year.3. If you DO NOT have any relative with breast cancer, repeat the mammogram every 2 years.4. Breast self examination should NOT replace the mammogram as a screening tool. Sure, you may perform a monthly breast examination on yourself. But this does not free you from your obligation to yourself of having your yearly mammography.
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