A woman's decision about when to start breast cancer screening mammograms should be a matter of personal choice, not association guidelines. A recent study in Cancer looked at the differences in likely outcomes of various breast cancer screening guidelines. Screening mammography recommendations for early detection of breast cancer still differ between medical associations that advocate annual breast cancer screening starting at age 40, the American College of Radiology and the American Cancer Society, and others that recommend starting biennial screening starting at 50, the U.S. Preventative Services Task Force and the American Academy of Family Practice. The screening recommendation a woman receives unfortunately depends on who is giving it rather than the patient. This study provides information that a woman should know when deciding which breast cancer screening strategy is right for her:
The controversy about whether breast cancer screening with mammography increases survival or only causes anxiety and healthcare costs for women contniues. A recently published Norwegian study on mammography screening and breast cancer mortality looked at all Norwegian women aged 50 to 79 between 1986 and 2005. Norway provides an ideal setting to evaluate the effects of breast cancer screening because of the well-defined population and access to medical records. The study shows that breast cancer screening with mammography reduces deaths from breast cancer by 28%.
Late stage breast cancer in young women is increasing in frequency according to a new report that analyzed the U.S. National Cancer Institute Surveillance, Epidemiology and End Results (SEER) database. The incidence of Stage IV breast cancer in young women has increased at a rate of about 2% a year since 1976. Although the absolute number of young women who are diagnosed with advanced disease is a small one, it has doubled from 1.5 women per 100,000 to 2.9 per 100,000. This increased incidence of Stage IV disease was found in young women of all races, but was especially prominent in blacks and non-Hispanic whites.
Breast cancer studies have looked at how cancer genetics, size, co-existing medical conditions and socioeconomic status affect outcome, but for the first time a study has looked at how delayed treatment affects survival. A new study looked at how a delay in treatment after biopsy confirmed diagnosis affects patient survival and found that for late stage cancers, this amount of treatment delay led to lower survival compared with other women similarly staged who did not suffer a delay in treatment. The study involved Medicaid patients in North Carolina who were diagnosed in 2000 - 2002 and were followed until July 2006.
Breast cancer causes both immediate and long lasting injuries to women. A recent study in Australia reports that adverse changes to sexual well-being and intimacy are the most problematic issues for women after the diagnosis. The study examined changes to sexuality and intimate relationships in such patients. Decreases in sexual frequency, response and satisfaction were caused by a number of factors related to the disease and its treatment. Tiredness and pain, psychological distress and a poor body image develop. Medical and/or surgical menopause to stop hormonal stimulation of the cancer causes vaginal dryness, hot flushes and weight gain. These emotional and physical changes that occur cause feelings of unattractiveness, loss of femininity and have negative impact on relationships with spouses and partners.
Surgery for breast cancer after initial diagnosis is taking longer. A study at Fox Chase Cancer Center in Philadelphia of women between 1992 and 2005 showed that the average time between diagnosis and surgery increased from 21 days to 32 days. The time from the first cancer related visit to biopsy also increased. This increased treatment delay was greatest for black and Hispanic women and people who live in large cities. Although it is unknown how much of a difference this delay is making, the trend is problematic.