The new breast cancer screening guidelines announced November 16th by the U.S Preventive Services Task Force have sparked widespread anger and confusion. The debate centers on the relative risks and benefits of various methods of trying to pick up breast cancer at an early stage. All current techniques, including mammography, MRI, ultrasound, and breast exam, can reveal abnormalities that end up being benign. These so-called “false positives” often lead to expensive, anxiety-producing, and invasive testing such as biopsy and fine-needle aspiration. The big question is: What screening tests are “worth it” and how do we define “worth it?” Read more »
Dr. Avrum Bluming is a medical oncologist and clinical professor of medicine at the University of Southern California. He is also a dear friend, scientist, and careful analyzer of data. I asked him to help me understand the current mammogram guidelines debate, and what women (now faced with conflicting recommendations) should do about breast cancer screening. Please listen to his fascinating discussion captured here:
What I learned is that the guidelines must be tailored to each woman’s unique situation. The variables that must be considered are incredibly complex, as breast cancer risk factors include everything from when and if one has given birth, to a history of smoking, drinking, overweight, breast cancer in the family and even the age of your parents when you were born. Beyond risk factors, new research suggests that some breast cancers spontaneously resolve without treatment, but our technology is not advanced enough to distinguish those from others that will go on to become life-threatening tumors – so we treat all cancers the same. Read more »
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