Mammography (Mammograms) is an X-ray radiographic examination to check for breast cancer, a screening mammogram for breast cancer early detection, diagnostic mammography is a lump or a screening mammography appear appear in the breast further positive results after the diagnosis. This technique appeared in the 1950's, is currently very popular with Western countries, most countries recommend annual women over the age of 50, the United States is even more radical, it is recommended for women over the age of 40 inspection.
In 2009, the US Preventive Services Expert Group (USPSTF) to make new recommendations, it is recommended for women aged 74 to 50 years to do a mammography every two years, the proposal caused an uproar, women's organizations have protested, leading to the American Cancer Society, the US National cancer Institute and other authorities recommend no change to the original, it's still recommended for women from the age of 40 do a mammography every year.
This USPSTF recommendation is based on the following points.
One of the hazards of radiation. Mammography radiation is ionizing radiation may cause cancer, a screening mammography is low radiation intensity of about 0.4mSv, a few studies found that healthy women mammography inspection and inspection of high-risk groups are not compared to , the risk of breast cancer increased by 1.5 times, screened high-risk groups and those who do not accept the screening compared to risk of breast cancer increased by 2.5 times, which several studies are small, not enough to describe the problem. If delayed mammography age, annual change for the first two years, because it is the possibility of cancer many years later to appear, the person may not be able to live to age thus obtained cancer. But for those with BRCA1 / BRCA2 mutations who have to pay attention, because of the low dose radiation on genetic mutation big impact.
Second, the false negative. Since breast density reasons, about 20% of breast cancer is mammography can not be found out, these false negative occurs mainly in young women who, because as they age, breast density will decrease. False negatives can lead to delay treatment.
The third is a false positive. Also common in young women. False positives can lead to accept the excessive radiation, because false-positive to go through a diagnostic mammography to exclude, and some people even biopsy. False positives can also cause psychological shadow. Some studies have found that if after a decade of inspection, it would be up to 60% of women experienced a false positive. Studies have found that 20-year period, the false positive rate for women over the age of 40 is not high, only to 1/424 ,.
Fourth, overdiagnosis and overtreatment. This is the most critical, but also in recent years in cancer screening very controversial topic, many tumors are screening there is a problem of over-diagnosis and over-treatment. Overdiagnosis refers to a part of breast cancer is no symptoms, it will not endanger the patient's life, just because mammography this technology was diagnosed. Over-treatment because the doctors can not know what is needed to treat breast cancer, which does not require treatment, all treatment only, need not have the results of those patients receiving a cancer treatment. Side effects of cancer treatment are usually large, become cancer patients, the patient's quality of life will be greatly decreased, even life will be shortened. If you postpone doing or do less often, over-diagnosis and over-treatment would be much less.
USPSTF recommended against dissenting voices are emphasizing a screening mammography can save lives, it is worth paying these types of above price. This sound was very strong, but has just published a paper on this issue a strong challenge.
February 11 published in the "British Medical Journal" This article is a follow-up study of Canada's 25-year, nearly 90,000 women aged 40-59 to participate, half of women do annual mammography plus breast examination half of women as a control group for only breast examination. After 20 years, mammography breast cancer group had 3250 cases, 3133 cases of breast cancer occurred in the control group. So far, the mammography group died 500 cases, 505 cases in the control group died, that annual mammography screening did not reduce breast cancer mortality.
Can reduce mortality, it is not life-saving, early diagnosis of this technique is also worth continuing popularity of it? At least 40 years of age to re-evaluate the recommended annual inspection.
The study also found that over-diagnosis rate of annual mammography screening was 22%.
Overdiagnosis causing over-treatment, but from another point of view, due to cancer treatment, there are a large part of the tumor despite early detection, but the treatment was not effective means of early detection and prognosis almost. While the other part due to advances in the treatment of cancer, early detection although not as good prognosis after treatment, prognosis and early detection. Since tumor therapy progressed very quickly in recent years, the value of early diagnosis of getting down.
The study included only women 60 years of age, and therefore made in 2009 USPSTF recommendation on mammography screening postpone age is consistent. Whether this will affect the study recommends that States official on mammography screening is unknown, in this case, USPSTF screening every two years over the age of 50 is a good choice.
In addition to mammography, the women have to learn to self, find lumps and other irregularities after going to see a doctor immediately. Have a family history of breast cancer but also to see a doctor as soon as possible, if there BRCA1 / BRCA2 mutations, you can consider breast surgery.
Early detection of breast cancer is better to prevent breast cancer, the causes of breast cancer, some people can not control, and some can be controlled, such as by regular exercise, maintaining a healthy weight, not smoking and other measures may reduce the risk of breast the risk of cancer.
In addition, in the diet should be noted that some studies have found high-fat dairy products will increase more than 50% mortality in patients with breast cancer also increases the risk of cancer, so eat low-fat or nonfat dairy products. Research also found that eating foods rich in folate may reduce the risk of breast cancer. Eat soy, sunflower or pumpkin seeds are likely to reduce the risk of breast cancer.
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