Screening DiagnosticMammography.ppt

Screening DiagnosticMammography Julie Lyons MS3 December 2004 Screening and Diagnostic Mammography To screen or not to screen? Click here for current recommendations I’m not going to get breast cancer! Click here to learn about risk factors What the heck is that white speck? Click here to learn how to read mammograms Ouch!! That hurts! Click here to learn about adverse effects Yikes, the doc called me back! Click here to learn about diagnostic imaging Are they ever going to stop squishing my breasts? Click here to learn about new/experimental breast imaging methods References and practice cases No good screening test comes without… CONTROVERSY!!! Although the recommendations are clear… The story is not. U.S. Preventive Services Task Force (B) Screening mammography (+/- clinical breast exam) reccomended every 1-2 years for women 40 years old (I) Insufficient evidence to reccommend for/against: - routine CBE alone - teaching or performing routine breast self exam (BSE) American Cancer Society “Women age 40 and older should have a screening mammogram every year, and should continue to do so for as long as they are in good health.” “Women at increased risk should talk with their doctor about the benefits and limitations of starting mammograms when they are younger, having additional tests, or having more frequent exams.” American College of Radiology “Annual screening mammography is indicated for asymptomatic women 40 years of age or older.” “It is reasonable to institute screening mammography at an earlier age for women with high risk factors.” “Decisions when to stop routine mammography screening should be made on an individual basis by each woman and her physician.” What do the data say? Recommendations on screening mammography are derived from 7 long-term international studies Multiple meta-analyses have since been done The validity of some of these RCTs has been questioned which has lead to different conclusions about the effi