July 13, 2015 |
In the ongoing debate over the pros and cons of breast- cancer screening with mammograms, one of the hottest issues is overdiagnosis - and its potential dangers to women. "Overdiagnosis is the diagnosis of a tumor that would not have become clinically apparent in the absence of screening," explains an editorial in last week's JAMA Internal Medicine. "Treatment of an overdiagnosed tumor cannot provide benefit, but it can lead to harm. " The editorial accompanies a new study that investigated the problem by using government data to correlate use of mammography in 547 U.S. counties with breast-cancer incidence and deaths over a decade.
June 26, 2014 |
A national study of nearly half a million women found that adding three-dimensional breast imaging to standard two-dimensional mammography increased cancer detection while reducing recalls for false alarms. The new X-ray technology, called tomosynthesis, was approved in 2011 and is still considered experimental by insurers, who do not cover it. Nonetheless, 3D is catching on. The study, published in Wednesday's Journal of the American Medical Association, involved 13 academic and community breast imaging centers, including two in Philadelphia - at Albert Einstein Healthcare Network and the University of Pennsylvania.
October 18, 2012 |
Despite ongoing debate over the value of screening mammography, use of breast X-rays has remained high over the last decade in Southeastern Pennsylvania. In 2010, 65.4 percent of women age 40 and older in the five-county region had a mammogram within the previous year. That proportion is slightly lower than the peak of 68.6 percent in 2000, but it is dramatically higher than in 1991, when little more than half of eligible women reported being screened, according to survey data from the Public Health Management Corp.
February 12, 2011 |
The U.S. Food and Drug Administration on Friday approved the first three-dimensional system for breast-cancer screening, an advance expected to enhance detection while reducing false alarms and needless biopsies. The system, made by Hologic Inc. of Bedford, Mass., is approved in Europe and has been widely tested in the United States, including in Philadelphia at Albert Einstein Medical Center and the University of Pennsylvania. "The average radiologist is going to be better" at spotting breast cancer, predicted Andrew Maidment, a medical physicist at Penn.
November 21, 2009
Bad advice on breast cancer The bean counters have decided that women under 50 don't need screening mammograms because only a small number will die ("New mammography advice: Less is more," Tuesday). They also decided that women over 74 needn't be screened. They cite the so-called harm of anxiety, added testing, and possible biopsies resulting from false positives. These are nothing compared with the consequences of failure to detect. In 1952, a young woman of my acquaintance died of breast cancer at the age of 33. Screening might have detected it early enough to save her life.
April 5, 2007 |
Computer software designed to improve radiologists' interpretation of mammograms actually reduces their accuracy, resulting in more retesting and biopsies that find no breast cancer, a major new study concludes. The surprising findings belatedly cast doubt on the value of "computer-aided detection," a nine-year-old technology that has been widely adopted and touted as the coming standard in breast-cancer screening. Joshua J. Fenton, lead author of the report in today's New England Journal of Medicine, said more than one-quarter of the nation's mammography facilities have invested up to $240,000 each to add computer-aided detection.
October 20, 2004 |
SOMEWHERE, after Melissa Etheridge's breast cancer became public knowledge, someone expressed surprise that lesbians could even get the disease. As if certain sexual activity protects people. But while Etheridge, 43, is definitely high-profile, she's hardly the only lesbian ever diagnosed with breast cancer. One in eight women in the U.S. will get breast cancer in their lifetime - more than 40,000 women will die annually. There are no firm statistics that lesbians are more or less affected, but because some have no need to see an "ob," they fail to understand they still need the "gyn.
March 12, 2003 |
I went to the doctor recently for my annual humiliation, also know as The Exam. Why do they make you strip and then dress you in paper, which rips when you sit, offers absolutely no warmth, and crinkles every time you shift while waiting an eternity for the doctor? And why, oh, why do they air-condition the examining room even in winter? There I was, dressed in a paper gown, staring at the stirrups and dreading the whole forthcoming ordeal. I love it when, during The Exam, the doctor makes small talk and keeps repeating, "Relax.
February 18, 2002 |
CONFLICTING judgments about the value of routine mammography have left women in a quandary. As a fiftysomething woman and an epidemiologist tracking the data, I believe that for now women 50 to 69 should stay the course and continue to have regular mammograms. But we ought not to dismiss concerns about flaws in the existing data, and women should know why experts are not speaking with a single voice. The evidence that mammography does work is weaker than we used to think. Also, everyone weighs benefits and risks differently.
February 4, 2002 |
When the subject is mammography, researchers often sound like children squabbling in a school yard. "Early detection of breast cancer saves lives. " "No it doesn't. " "Does. " "Doesn't. " After 40 years of this, the dispute still isn't settled. That's why two Danish researchers reviewed the world's seven major studies of mammographic screening. They concluded two years ago in the Lancet that "screening for breast cancer with mammography is unjustified. " They reasserted that conclusion three months ago in a review in the same British medical journal.