Posted on 11/18/2009 8:13:03 PM PST by neverdem
SAN FRANCISCO — Only 21% of Massachusetts women older than age 40 years were not in mammographic screening programs. Yet unscreened women accounted for 75% of the breast cancer deaths in an analysis of data on 6,997 invasive breast cancers diagnosed in 1990-1999 and followed through 2007.
“The most effective method for women to avoid death from breast cancer is to have regular mammographic screening,” Dr. Blake Cady said at a breast cancer symposium sponsored by the American Society of Clinical Oncology, where he presented the data.
Extrapolation from the study's results suggests that for the projected 192,370 women nationwide diagnosed with invasive breast cancer in 2009, the overall 12.5-year mortality rate of 15% represents rates of 4.7% among regularly screened women and 56% among unscreened women, according to Dr. Cady, professor of surgery at Brown University in Providence, R.I., and professor of surgery emeritus at Harvard Medical School in Boston.
That 56% mortality rate is “the same overall mortality we used to see in breast cancer up until 1970, prior to the onset of widespread mammographic screening,” Dr. Cady said.
These findings confirm previous studies that found 25%-40% reduced mortality in women who were offered mammographic screening and greater than 50% reduced mortality in women who actually received mammograms, he noted.
The results of the current study “clearly support the findings of the trials—that we must encourage our patients to undergo routine screening mammograms,” Dr. Lori Pierce, professor of radiation oncology at the University of Michigan, Ann Arbor, commented at a press briefing.
Dr. Cady and his associates identified 461 patients who died from breast cancer during a median follow-up of 12.5 years and whose hospital and outpatient medical records were available for review. Women were considered to be in mammographic-screening programs if they'd had two or more screening mammograms at intervals of 2 years or less when asymptomatic.
Data from the 1995 Behavioral Risk Factor Surveillance System suggested that approximately 79% of Massachusetts women aged older than 40 years were in mammographic screening programs in 1995.
Among the 461 breast cancer deaths that occurred during the current study, just 116 (25.2%) were in regularly screened women. These included 72 (15.6%) deaths from nonpalpable cancers detected on screening mammography and 44 (9.6%) from palpable cancers detected during an interval between scheduled mammograms, reported Dr. Cady.
The 345 breast cancer deaths (74.8% of the total) in women who were not regularly screened included 322 (69.8%) in women who had never been screened by mammography and 23 (5%) deaths in women who had received one or more previous mammograms, but not within the 2 years before diagnosis of breast cancer.
“Even in women in their 50s and 60s, who are ideal candidates to be screened, there are many women who are not getting screened,” Dr. Cady said. “We should put lots of effort into trying to get them screened, since that's the best way for them to avoid death from breast cancer.”
The 79% rate of regular mammographic screening in Massachusetts is a relatively high rate, compared with rates in other states, and is second only to that of Rhode Island, he noted.
The reasons for this success are unclear, but could be due to better publicity for screening programs, or greater physician awareness and encouragement of screening, or other factors, Dr. Cady suggested in an interview after his presentation.
The lack of screening could be due to many factors such as other illnesses, older age, poverty, language barriers, a history of cancer, or medical advice not to get mammograms for other health reasons, he noted.
Dr. Cady and Dr. Pierce reported having no conflicts of interest related to the study.
Obama’s Death Panels disagree!
Breast Cancer Awareness activists tend to be very visible. Pink ribbon campaigns are everywhere. Next time I see anyone who “cares deeply” about breast cancer, I plan to politely get in their face and ask them to choose between allegiance to Obama and concern for breast cancer. I don’t think they can have it both ways.
WOW! A gift to the RNC...hopefully they use it...BUT I DOUBT IT!!
Elizabeth Edwards has been silent on this issue...
Excellent idea!
Have you heard anything from NOW?/s;)
Barack Hussein Obama...mmm...mmm...mmm.
Spending untold millions and billions to detect 1 in 1900 is not cost effective and results in higher premiums and higher medicare/medicade taxes for everybody.
At one time the GOP represented fiscal responsibility..now their strategy is to get in a bidding war with the Dims hoping to buy votes..
http://www.costhelper.com/cost/health/mammogram.html
Do you believe that mammograms are what are driving up the cost of insurance? My kids' annual checkups cost more than this.
It doesn't bother me if people spend their own money for them.
These are very difficult issues.
I am opposed to the expansion of the Gov’t’s role in Healthcare. I am a retired married male and pay my own very substantial insurance premiums. I have no ties to insurance companies, etc. but I have had to decide on insurance coverage for a small 40 employee company.
There is no doubt that Mammograms allow for earlier detection and better treatment of breast cancer. However, Mammograms do have very high false positive results. I think the issue of when Mammograms should be encouraged and covered by Insurance Companies is a matter of empirical science and an assessment of risks. I can’t find a copy of the study mentioned in the above article but the information in the article is presented in an unhelpful way. The issue of concern is the age at which Mammograms should be covered for early detection when an individual is not in a higher risk group. The article makes no mention of the ages and known risk factors of the unfortunate women who died. Without this information it is impossible to say how relevant the study is to the issue at hand. Blindly attacking what may be a legitimate effort to limit unnecessary testing is not wise. After all, one can always pay for one owns testing whether it is for breast or prostate cancer.
OK Ladies the real reason we dont go for our yearly is the pain of being tortured.
I can testify that the new imaging mammo are awesome and I dont have to hear the Doc reading the mammo whine and make me do a re take due to my use of sythetic thyroid replacement therapy.
The new machines are so non painful and read in a more diminsional way aka better diagnosis.
And we live in a rural rural area but have the new updated non cruel mammos.
My Cheerios package came wrapped in cellophane so it
could inclose a huge Pink ribbon sticker with Cheerios
name on it.
I thought Come On it probably cost more money to
produce those stickers (I tossed mine out. To big and
Ugley to STICK anywhere IMO)and then enclose them
with cellophace around the whole dang box then the
money Cheerios is actually donating to the cause.
THe article posted makes a good case for screen mammos. If you look at the death rates which are very high in unscreen cancer, it is clear that the 1/1900 has to have factored in not only the small cost of mammograms but the increased cost of later treatment of undiagnosed early cancer versus undiagnosed later cancer.
Early cancer, small confined non invasive lesions is easily treatmed with either lumpectomy and sentinal node biopsy. Compare the cost of that to diagnosis at a later stage which will involve the above plus chemo, radiation and perhaps mastectomy.
When you factor in the costs for later treatment due to lack of screening, the cost in loss of life is apparent as well as the very high cost of treatment.
I know,,I am in treatment for cancer and the costs are astronomical. An early diagnosis would have resulted in far more savings.
Statistics such as the one you quote 1/19oo don’t take into account the ultimate costs as well as the untimate deaths of women who did not need to die.
THe article posted makes a good case for screen mammos. If you look at the death rates which are very high in unscreen cancer, it is clear that the 1/1900 has to have factored in not only the small cost of mammograms but the increased cost of later treatment of undiagnosed early cancer versus undiagnosed later cancer.
Early cancer, small confined non invasive lesions is easily treatmed with either lumpectomy and sentinal node biopsy. Compare the cost of that to diagnosis at a later stage which will involve the above plus chemo, radiation and perhaps mastectomy.
When you factor in the costs for later treatment due to lack of screening, the cost in loss of life is apparent as well as the very high cost of treatment.
I know,,I am in treatment for cancer and the costs are astronomical. An early diagnosis would have resulted in far more savings.
Statistics such as the one you quote 1/19oo don’t take into account the ultimate costs as well as the untimate deaths of women who did not need to die.
I am an avid proponent for transvaginal ultrasound as part of routine screening to detect uterine and ovarian cancers. The test is very low risk, requires minimal preparation, and reasonable cost. I think far too many women are lulled into a false sense of security via annual Pap tests for cervical cancer. You and I know the Pap is not sensitive to endometrial and ovarian cancers.
not only transvag ultrasound but CA123,,both cheap. THe problem with OVCa IS over 73 percent diagnoses are at state 3 or greater and rare if any cures then. ANd gyns don’t detect it on exam even when it is spreading. Symptoms are vague and women go on for months and years complaining of things that nobody takes seriously. And then when diagnosed not only is the prognosis grim but treatment is exspensive and very very hard.
Just doing these screenings would save lives and they won’t recommend them because of cost and false positives which require biopsy.
I would have gladly done them but didn’t know that I was at risk and with any first degree relative with breast cancer, the risk doubles. I had no idea and I am a physician.
So I was diagnosed late and just finished, yesterday, 14 months of the dreaded chemo.
Women should be spared this. With a diagnosis confined to ovary, treatment is much easier, high cure rate and lives saved.
We are in agreement,,I just wish ovca had the clout that breast ca has, or even aids. They get screened at least.
plus if breast cancer occurs in one first degree relative, women should insist on transvag ultrasound and a Ca 125 yearly,,and fire the gyn who refuses.
All three of my daughters are now high risk for ovarian and breast cancer. I had the BRCA testing done and it was negative so they didn’t need the testing done.
Women need to take charge of their health care and be partners with docs, not patient patients who listen to everything and do what told.
I have dead friends who had self discovered masses of breast not biopsied for months while the doc ‘watched” it,,now I tell all friends, if it is there, it must be biopsied within a month.
ANd listen to your dogs! My sister said her dog she had for years started burrowing his nose into her breast for months,,very uncharacteristic and she thought he was going nuts. She felt and found a mass,,Breast Ca. I have heard this story other times.
So if your dog says you smell funny, get it checked out. They are training dogs to sniff out cancer now,,
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