Worried about breast cancer?

Breast cancer is a common cancer in women.  Approximately 12.3 percent of women will be diagnosed with breast cancer at some point during their lifetime, according to the National Cancer Institute.  So if you are worried about breast cancer it is very natural and you are not alone.

Recently, the U.S. Preventive Services Task Force issued a draft guideline for breast cancer screening:

  • Women ages 50 to 74 should get a mammogram every two years (Grade B).
  • Women ages 40 to 49 should make their own decision whether to get a mammogram, in consultation with their doctors. This decision should be based on their health history, preferences, and how they value the different potential benefits and harms of screening (Grade C).
  • The Task Force also concluded that there is insufficient evidence (Grade I) to recommend for or against the following, and is calling for additional research in these three areas: 1) mammograms for women aged 75 and older, 2) tomosynthesis (3D mammography), 3) adjunctive screening for breast screening using ultrasound, MRI, tomosynthesis or other modalities in women identified to have dense breasts on an otherwise negative screening mammogram exam.

This is a good GUIDELINE not only for healthcare professionals but also women considering their breast screening for breast cancer.  It takes into consideration of potential benefit and harm that a screening can bring.

What is Grade A, B, C, I….? Check the table below.

 

Grade Definition Suggestions for Practice
A The USPSTF recommends the service. There is high certainty that the net benefit is substantial. Offer or provide this service.
B The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial. Offer or provide this service.
C The USPSTF recommends selectively offering or providing this service to individual patients based on professional judgment and patient preferences. There is at least moderate certainty that the net benefit is small. Offer or provide this service for selected patients depending on individual circumstances.
D The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. Discourage the use of this service.
I The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined. Read the clinical considerations section of USPSTF Recommendation Statement. If the service is offered, patients should understand the uncertainty about the balance of benefits and harms.

 

 

 

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2 Responses to “Worried about breast cancer?

  • On the other hand, the USPTF clarifies the new breast cancer screening guideline as follows:

    MYTH: The Task Force recommends against screening for breast cancer in women younger than 50.
    FACT: Evidence shows that mammography screening can be effective for women in their 40s. Based on the science, the Task Force’s draft recommendation states that the decision to start regular mammography screening before age 50 is an individual one and should be made by a woman in partnership with her doctor.

    MYTH: The Task Force is recommending against 3-D mammography screening.
    FACT: The Task Force is unable to make a recommendation for or against 3-D mammography screening because there is not enough evidence to determine whether it will result in improved health or quality of life or fewer deaths among women. More research is encouraged.

    MYTH: The Task Force is recommending against additional screening in women who have dense breasts.
    FACT: The Task Force is unable to make a recommendation for or against additional screening in women who have dense breasts because the evidence is unclear whether it will help these women. More research is encouraged.

    MYTH: There are no significant harms of screening for breast cancer.
    FACT: One serious potential harm of screening is overdiagnosis and overtreatment, or unneeded detection and treatment of cancer that would not have become a threat to a woman’s health during her lifetime.

    MYTH: Mammography screening is not covered by insurance companies because of the Task Force’s draft recommendation.
    FACT: The draft recommendation on breast cancer screening will not affect insurance coverage. Mammography is a screening service generally covered by all public and private insurance plans without co-pays or cost-sharing for patient. Individuals with questions should contact their health insurance provider.

    MYTH: The Task Force does not focus on women’s health.
    FACT: The Task Force cares deeply about the health of all Americans, and has many recommendations related to women’s health, including screenings for cervical cancer, intimate partner violence, and pregnancyrelated diabetes. Our goal is to empower women with the data so they can make the best health care decisions for themselves.

    MYTH: The Task Force does not recommend mammography screening.
    FACT: The Task Force recognizes that mammography is an important tool in reducing breast cancer deaths. The science shows that screening is most beneficial for women ages 50 to 74. The decision to start screening before age 50 should be an individual one, recognizing the potential benefits and potential harms.

  • Some group of people, however, is not happy with the new draft guideline for breast cancer by the USPTF. These are excerpts from the stoptheguidelines.com website:

    “…That’s why we are concerned about new breast cancer screening recommendations proposed by the US Preventive Services Task Force (USPSTF or Task Force). The draft recommendations give annual mammograms for women ages 40-49 a “C” grade, meaning most women in this age group, according to the Task Force, do not need an annual exam. The proposed recommendations also state that women 50-74 need mammograms only every other year. You can review the proposed recommendations in more detail here.
    What’s at Stake?

    If finalized as proposed, the recommendations could limit access to lifesaving mammography exams. In light of the “C” grade, insurance companies would no longer be required to cover mammograms without cost sharing (co-payment or deductible) for women ages 40-49. The impact would be far reaching, affecting 22 million women between the ages of 40-49. This would include 2.8 million African American women, who have the highest rate of mortality from breast cancer and also are 45% less likely to have health insurance than white women.
    How Many Cancers Are We Willing to Miss?

    For many women in America, having to pay for a mammogram would be a deterrent to getting this critical exam. Women would continue to delay their mammogram or not go at all, meaning cancers would go undetected or caught at a later stage when mortality rates are higher and more invasive treatments are needed.
    Which of our mothers, wives, daughters, grandmothers, sisters, and friends is it okay to lose?
    Even More Accurate Exams are at Risk

    The Task Force also found the evidence regarding 3D mammography to be insufficient. It dismissed hundreds of peer-reviewed publications that clearly and consistently show 3D mammography significantly increases the detection of invasive cancer while reducing false positive recall rates – all of which are key concerns about conventional mammograms raised by the Task Force.”

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