National Post (Latest Edition)
EARLY BREAST SCREENING SAVES LIVES
Breast cancer is the second leading cause of cancer death in Canadian women, but early screening for breast cancer can produce a better outcome.
Weighing the risks and benefits
Screening mammography is the process of checking healthy women to make sure that they don’t have signs of breast disease and for those who do, it could mean the difference between longer or shorter life.
The main benefit of early screening is the potential for early detection of breast cancer at a stage, which is more easily treated. Dr. Shiela Appavoo, Chair, Canadian Association of Radiologists Practice Guidelines for Breast Imaging confirms, “early detection is associated with better chances for survival.”
The risk of radiation is small and is outweighed by the benefit of finding cancer early and increasing your life span. Other risks include being called back for additional imaging and a small number of people may have a biopsy, which is a minimally invasive procedure where most women do not require sedation nor are they left with a scar. A very small minority of women, however, do get open biopsies, depending on the type of lesion or results from their first biopsy.
Dr. Appavoo also mentions a risk of getting treatment for cancer that might not shorten your lifespan. “There are a small number of patients who have a cancer that may not have killed them and they get treatment for that.”
Unfortunately, there is currently no way to distinguish between the cancers that will progress from those that won’t. Because of this most women choose to undergo treatment.
Data shows that there are two main factors associated with increased risk of death from breast cancer: large tumor size at diagnosis and positive lymph nodes.
“If you’ve got lymph nodes that have cancer in them at the time you’re diagnosed, your chances of survival fall significantly,” says Dr. Appavoo. “Patients who go for screening mammography are less likely to show a large tumor or positive lymph nodes. So when you don’t screen, you are running the risk of missing your window of opportunity to catch a tumor early.”
Start the routine
The Canadian Association of Radiologists recommends starting routine screening for all women from age 40, and this recommendation is in line with a number of other cancer care and women’s care groups, including the American Cancer Society, American Congress of Obstetricians and Gynecologists, American College of Radiology and the Society of Breast Imaging.
Dr. Appavoo adds, “we encourage physicians and their patients to talk about when to start breast cancer screening, and to make decisions about their health care that are based on evidence and informed dialogue.”