Hello students: In previous weeks we have been reviewing the prevalence, mortality and morbidity associated with breast cancer. This is a topic of extreme public and personal interest. Primary care providers deal with the diagnosis, and the screening of breast cancer on a daily basis. Therefore, in this discussion we will discuss about the importance of understanding the advantages and limitations of its screening
Breast cancer screening is often done through physical exam and also biopsy, but there is some dilemma on cases of over-diagnosis of ductal carcinoma in situ (DCIS) where evidence shows there is now clear evidence that between 10 and 50% of invasive cancers detected and treated radically as a result of screening would never threaten life (Hughes et al., 2014). The benefit of screening healthy populations by mammography was questionable and had little, if any, effect on mortality. But these concerns have not been shared with women invited to participate in screening.
The main benefit of mammography screening is reduction of breast-cancer related death. Overdiagnosis of breast cancer is the main harm of mammography screening. Based on recent estimates from the United States, the relative amount of overdiagnosis (including ductal carcinoma in situ and invasive cancer) is 31%. This results in 15 women overdiagnosed for every 1,000 women invited to biennial mammography screening for 20 years from age 50 (Brandãoa, Tavares, Schulz & Matosa, 2016).
Brandãoa, T., Tavares, R., Schulz, M. S., & Matosa, P. M. (2016). Measuring emotion regulation and emotional expression in breast cancer patients: A systematic review. Clinical Psychology Review, 43, 114-117. doi:10.1016/j.cpr.2015.10.002
Hughes, S., Jaremka, L. M., Alfano, C. M., Glaser, R., Povoski, S. P., Lipari, A. M., . . . Kiecolt-Glaser, J. K. (2014). Social support predicts inflammation, pain, and depressive symptoms: Longitudinal relationships among breast cancer survivors. Psychoneuroendocrinology, 42, 38-44. doi:10.1016/j.psyneuen.2013.12.016