1. One size doesn't fit all

    New studies bring clarity on Mammograms


    Two new studies help clarify an important issue that has had doctors in an upheaval over when women should begin getting mammograms, how often and at what cost. These studies found that women who have a mother or sister diagnosed with breast cancer, or those who have unusually dense breast tissue, should have their first test at age 40 and repeat the exam at least once every other year. The research was designed to identify women who could benefit the most from having mammograms early and often.

    Both studies arrive at their conclusions through different ways. One involved combining and analyzing data from 61 studies that have already been published. The other used computer models to predict the health outcomes of about 44,000 simulated women who had their first mammogram at 50. They then ran the same women through a simulation in which they began screening at 40 and compared the rates of false alarms, breast cancer diagnoses and mortality in both groups.

    The findings push further away from what many have since called "one size fits all" medicine and toward an approach more tailored to the individual patient and her risks.

    Breast density came to the forefront of the research. One of the studies them found that having breasts made up of substantially more glandular tissue rather than fat was enough to double a woman's breast cancer risk in her 40s. In this respect Dr. Patricia Ganz, a breast cancer specialist at UCLA the key risk factor of breast density needed better definition if it was to be a helpful guidepost to women and their doctors. Radiologists, who review mammograms, and primary-care doctors have no established standards or software that defines and grades breast density, she said, so sending all 40-year-old women to have their breast density assessed would be premature.

    Full Article







































    "For these women, who face at least twice the average risk of developing breast cancer in their 40s, the benefits of routine screening between the ages of 40 and 49 outweigh the risk of false alarms and unnecessary work-ups that might otherwise put them at greater risk than doing nothing, researchers report in Tuesday's edition of Annals of Internal Medicine"