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Article on the differing views of breast cancer screening

April 8, 2010

Over the past year, there has emerged two very contrary views to whether or not breast cancer screening has merit.  Last Fall, there was a major outcry when the U.S. Preventive Services Task Force announced that the age for first mammogram should be raised to 50.  Breast cancer screening engenders very emotional and heated debate.  The view put forth by Michael Baum, the doctor who introduced Britain’s first breast screening program more than 20 years ago, takes a middle of the road approach.  Instead of using the current one-size fits all strategy

Dr.  Baum proposes:  a “triage” system to divide women into high, middle and low-risk groups based on family history and lifestyle factors like alcohol consumption, weight, diet and exercise.

Baum says high-risk women — those with a long family history of breast cancer — should be offered genetic testing to find out if they have a gene mutation which predisposes them to the disease, while low-risk women should get advice on healthy eating, avoiding alcohol and minimizing other risk factors.  Screening would then be reserved for those in the middle, where he thinks the benefit-risk balance makes most sense.

Does mammogram row signal time for policy shift?

Reuters, Kate Kelland, Health and Science Correspondent – Analysis, LONDON, Wed Apr 7, 2010 12:38pm EDT

Almost any woman who had a cancerous tumor detected in her breast during a regular screening appointment would probably think the scan — and subsequent surgery, radiotherapy or chemotherapy treatment to remove the cancer — saved her life.

But that is not always true and an increasingly heated international debate is raging about whether women are getting the right information on the merits, and risks, of mammograms.

The fear is that over-diagnosis — when screening picks up tumors that would never have presented a problem — may mean many women are undergoing unnecessary radical treatment, suffering the physical and psychological impact of a breast cancer diagnosis that would otherwise not have come up.

While some scientists are locked in battle, slinging accusations at each other of misleading data and conflicts of interest, others say the row itself is a signal that it’s time for a new and more refined approach to breast cancer screening.  Read entire article here: http://www.reuters.com/article/idUSTRE6362FD20100407

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