Mammography Screening is Front and Center, Again

The controversy over screening women for breast cancer continued today with reports suggesting annual screening before 50 years of age may prevent advanced breast cancer. The data showed that women who forgo annual mammograms were more likely to find cancer at an advanced stage.

The USPSTF started the controversy when they came out with their recommendations in 2009. The Task Force didn’t discount screening at 40, but recommended that decisions be made on an individual basis after consultation with your doctor. For example, if you have a family history of breast cancer or have dense breasts, you and your doctor may decide to begin annual screening in your 40’s.

The problem with screening mammography at an early age is the detection of DCIS at a rate of 60,000 cases per year. DCIS is ductal carcinoma in situ, a pathology diagnosis which carries a very good prognosis, a 98% – 5 year survival with no treatment.   In spite of the rather benign natural history of DCIS, mainstream medicine treats these lesions aggressively with surgery and radiation.  Recently, the NIH has called for a change in terminology, asking pathologists to stop calling it “cancer”. 

What is troubling is despite treating all of these women with DCIS, the number of aggressive cancers and deaths from breast cancer have not changed, leading many to believe that screening for most women is unnecessary. Talk to your doctor to see if mammography is right for  you. And, if you decide to be screened and are diagnosed with breast cancer, get a second opinion from an expert! This cancer is overdiagnosed by inexperienced pathologists.

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