JAMA....Mammography...

voraciousreader

"Conclusions and Relevance  To maximize the benefit of mammography screening, decisions should be individualized based on patients’ risk profiles and preferences. Risk models and decision aids are useful tools, but more research is needed to optimize these and to further quantify overdiagnosis. Research should also explore other breast cancer screening strategies....."

http://jama.jamanetwork.com/article.aspx?articleid=1853165

voraciousreader

So, here we go again!  Following the recent BMJ study following Canadian women, another MAJOR medical journal tells us that it's time to reassess population based mammography.  The American College of Radiologists and Komen have already chimed in.  Their conclusion, is that until we have better tools at screening, they recommend sticking to annual mammography for ages 40 and older.

What these important studies tell us is the contrary.  They believe that a woman should discuss with her physician her personal risks and benefits of mammography and choose a screening plan that works for her.   This study was conducted by Harvard.  The limitation of discussing individual risks and benefits is that for the majority of patients 60%, there is no way of conclusively identifying those risks.

I know that for many, Dr. Esserman is controversial figure in the mammography issue.  However, following the BMJ's study of Canadian she said the following:

http://www.npr.org/blogs/health/2014/02/04/271554425/are-we-paying-8-billion-too-much-for-mammograms

I believe it's time to abandon the status quo.  Population based screening mammograms save lives, but not as many lives as previously believed.  It's time to have a "rational" discussion of mammography, as Dr. Otis Brawly would say.  Not "rationing" of mammography, but "rational" delivery of mammography....

voraciousreader

http://www.newswise.com/articles/jama-article-breast-cancer-screening-recommendations-potentially-deadly-for-many-women

Above link is a press release from the American College of Radiologists replying to the JAMA study.

coraleliz

I'm actually a Dr Esserman fan. When it was believed that I had DCIS, I had one foot out the door & on my way to UCSF. Without people like her there will be NO progress.

SelenaWolf

" ... Not "rationing" of mammography, but "rational" delivery of mammography...."

That is a good way to put it.  Personally, I think that it's a good idea; it approaches the problem by making it more pro-individual and ensures that those with a perceived higher risk get the care that they need.

LaurenN

... About the Canadian study that was downplaying the need for mammograms. 

New Canadian website to get rid of that false information launched....on Facebook....

https://www.facebook.com/MyBreastMyTest/photos/a.721543934574532.1073741826.719094984819427/725481634180762/?type=1

My Breast My Test

The Canadian National Breast Screening study has been widely discredited. The methodology of the study was flawed. The study was compromised because women received a physical examination by a trained nurse before their names were entered into the list. In addition, screening was based on outdated mammography technology that isn’t even in use today.
Huge advances have been made in breast cancer screening technology to improve the equipment, techniques, staff knowledge and expertise, and image interpretation by radiologists. The effectiveness of mammography screening has been well established by several large clinical trials.

voraciousreader

Lauren, what you are referring to comes directly from a press release that The American Academy of Radiologists posts each time the Canadian study releases its follow ups. To say the least, the population based screening mammography debate has become stale and tiresome.  With that said, recently, I'm beginning to read more articles that are more balanced....will that small change make more clinicians and patients begin an articulation about population based mammography vs individual risk screening mammography decisions?  I hope so because we all deserve better.  

LaurenN

The posting was simply to share information that was on the news, telling people to go to Facebook, to check out the site for information.  

Not a statement or opinion. 

Just information sharing, nothing more, nothing less.

voraciousreader

Lauren...please note above. I gave a link to the Radiologists' medical group's response to the Canadian study which you reiterate from Facebook.

Pointing out the Facebook link is important.  It shows how both sides of the debate are trying to get out their message.