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Mammograms
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A post from someone on here (and the ads on US tv) made me think. The guidlines in the UK state that mammograms should be undertaken every three years from age 48. In the States, they recommend having a mammogram every year. The powers that be in the UK state that too many mammograms can do more harm than good so who is right?
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A 2011 UK study concluded that annual mammography is desirable for those women who are at the highest risk of breast cancer but that 3-yearly checks are best for those who are at lowest risk.
Quote:
"Surveillance is likely to improve survival, with a strategy of mammography alone, every 12-24 months, appearing to have the highest net benefits. The evidence base on which to recommend any change in current practice is relatively weak, however. Careful consideration should be given to stratification of patients to ensure maximum benefit to ensure optimal use of resources, with those women with a greater likelihood of developing IBTR or MCBC being offered more comprehensive (e.g. mammography and clinical follow-up) and more frequent surveillance (every 12 months). The greatest net benefit for women with the lowest likelihood of IBTR or MCBC is mammography only every 3 years. Although there may be arguments for delivering a varying surveillance regimen this would present challenges and, without provision of information and reassurance, might be a source of unnecessary anxiety for patients"
Source:
http://
Quote:
"Surveillance is likely to improve survival, with a strategy of mammography alone, every 12-24 months, appearing to have the highest net benefits. The evidence base on which to recommend any change in current practice is relatively weak, however. Careful consideration should be given to stratification of patients to ensure maximum benefit to ensure optimal use of resources, with those women with a greater likelihood of developing IBTR or MCBC being offered more comprehensive (e.g. mammography and clinical follow-up) and more frequent surveillance (every 12 months). The greatest net benefit for women with the lowest likelihood of IBTR or MCBC is mammography only every 3 years. Although there may be arguments for delivering a varying surveillance regimen this would present challenges and, without provision of information and reassurance, might be a source of unnecessary anxiety for patients"
Source:
http://
>>>How does one know who is at the highest risk and the lowest risk though?
http://
http://
237SJ...just back from unpleasant couple of hours with my accountant...LOL
You have in the above posts, all the relevant links etc, so i will only add my personal comments arrived at by discussions with "mates" at lunch, in the pub and informal chats.
The medical profession cannot agree as to the periodicity of mammograms to provide early diagnosis.Some even question the value of mammograms (including myself) in affecting long term prognosis.
\\\\The powers that be in the UK state that too many mammograms can do more harm than good so who is right?\\\
Depends on what you mean. There is no doubt in my mind that many operations are performed needlessly on the back of mammogram interpretations. If you mean the effect of radiation on the body, then i think that all medical men agree that this is not a serious issue.
Does Mrs sqad have regular scans?.........No.
Has my post helped with your query?
You have in the above posts, all the relevant links etc, so i will only add my personal comments arrived at by discussions with "mates" at lunch, in the pub and informal chats.
The medical profession cannot agree as to the periodicity of mammograms to provide early diagnosis.Some even question the value of mammograms (including myself) in affecting long term prognosis.
\\\\The powers that be in the UK state that too many mammograms can do more harm than good so who is right?\\\
Depends on what you mean. There is no doubt in my mind that many operations are performed needlessly on the back of mammogram interpretations. If you mean the effect of radiation on the body, then i think that all medical men agree that this is not a serious issue.
Does Mrs sqad have regular scans?.........No.
Has my post helped with your query?
from Buenchico - my fave - he's great !
The evidence base on which to recommend any change in current practice is relatively weak,
which means in Plain English they are not sure if mammography works or not and they are even un-surer that making them more frequent will save more lives.
There are all sorts of surveillance that it stands to reason one should do,
but then if you do it doesnt seem to work.
Glucostats to diabetics should lead to much better control and therefore less complications - but in fact all it does is allow them to document terrible control and do nothing about it.
The evidence base on which to recommend any change in current practice is relatively weak,
which means in Plain English they are not sure if mammography works or not and they are even un-surer that making them more frequent will save more lives.
There are all sorts of surveillance that it stands to reason one should do,
but then if you do it doesnt seem to work.
Glucostats to diabetics should lead to much better control and therefore less complications - but in fact all it does is allow them to document terrible control and do nothing about it.
.
Oh dear we are not very pro-surveillance today, Sqad, are we ?
I had follow up post ca colon - for five years and was amazed at how crap it was - reduced a mortality of 50% to 47.5% .....
and that was a spiral scan once a year and one colonoscopy.
and so if anyone is interested in the calculation - in order to save one life (NNT number needed to treat ) - each person will cost say £5000
and you will need to do twenty to pick up one - so the cost to save that one is £100 000.
and can you spend £100k in a more effective way - I would have thought so.
Oh dear we are not very pro-surveillance today, Sqad, are we ?
I had follow up post ca colon - for five years and was amazed at how crap it was - reduced a mortality of 50% to 47.5% .....
and that was a spiral scan once a year and one colonoscopy.
and so if anyone is interested in the calculation - in order to save one life (NNT number needed to treat ) - each person will cost say £5000
and you will need to do twenty to pick up one - so the cost to save that one is £100 000.
and can you spend £100k in a more effective way - I would have thought so.
Buenchico's link is a good one, and it does call for more trials.
There is considerable dispute about this even in America.
In 2009 the US Preventive Services Task Force (USPSTF) made recommendations that mammography should begin at 50 rather than 40, and take place every two years, instead of yearly.
http://
From Cancer UK site..
"Research is comparing having mammograms once a year to mammograms every 3 years. Some studies show a slight increase in the number of breast cancers picked up with annual screening, compared to 3 yearly screening. But we need more research to see whether this actually saves more women's lives and what effect the higher exposure to radiation from yearly mammograms has."
From the same site a trial from 2002 showed no significant difference (in breast cancer mortality) between 1 year and 3 year screening.
So it's not just a matter of money - conclusive evidence that yearly mammograms are better is lacking.
Obviously for younger women with a strong family history or who are known to have a genetic predisposition the criteria are different.
On a more personal note, would I want yearly mammograms?
No.
There is considerable dispute about this even in America.
In 2009 the US Preventive Services Task Force (USPSTF) made recommendations that mammography should begin at 50 rather than 40, and take place every two years, instead of yearly.
http://
From Cancer UK site..
"Research is comparing having mammograms once a year to mammograms every 3 years. Some studies show a slight increase in the number of breast cancers picked up with annual screening, compared to 3 yearly screening. But we need more research to see whether this actually saves more women's lives and what effect the higher exposure to radiation from yearly mammograms has."
From the same site a trial from 2002 showed no significant difference (in breast cancer mortality) between 1 year and 3 year screening.
So it's not just a matter of money - conclusive evidence that yearly mammograms are better is lacking.
Obviously for younger women with a strong family history or who are known to have a genetic predisposition the criteria are different.
On a more personal note, would I want yearly mammograms?
No.
That'll teach me to have another cup of coffee before pressing submit - sqad's and PP's posts were not there when I started.
As to whether mammograms reduce the mortality from breast cancer, and if they do by how much - that is another can of worms.
There has been a battle royal in the BMJ since February of this year when they published a Canadian paper suggesting not....
http://
I know that seems to be intuitively the case gness - I suppose the answer might be that some small cancers spontaneously resolve without treatment.
As to whether mammograms reduce the mortality from breast cancer, and if they do by how much - that is another can of worms.
There has been a battle royal in the BMJ since February of this year when they published a Canadian paper suggesting not....
http://
I know that seems to be intuitively the case gness - I suppose the answer might be that some small cancers spontaneously resolve without treatment.
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