For the three million women in the United States who’ve survived breast cancer, difficult health care choices come with the territory. But even after successful treatment, an important question lingers: Should they consider magnetic resonance imaging (MRI) in addition to mammography for ongoing breast cancer screening, or “surveillance”?
A large national study in JAMA Internal Medicine has found that the rate of women receiving breast MRI (magnetic resonance imaging) nearly tripled from 2005 to 2009: from four to 11 exams per 1,000 women.
Researchers used electronic health records to identify Group Health patients who weren’t screened regularly for cancer of the colon and rectum—and to encourage them to be screened. This centralized, automated approach doubled these patients’ rates of on-time screening—and saved health costs—over two years. The March 5 Annals of Internal Medicine published the randomized controlled trial.
Among older women, getting a mammogram every two years was just as beneficial as getting a mammogram annually, and led to significantly fewer false-positive results, according to a Breast Cancer Surveillance Consortium (BCSC) study including patients and researchers from Group Health. The national study of more than 140,000 women between ages 66 and 89 is in the Journal of the National Cancer Institute.
The U.S. Preventive Services Task Force recommended in 2009 that primary care clinicians should screen adolescents for depression. But a positive result or screen does not mean that every young person needs active treatment—including psychotherapy and medication—for depression, based on a new study in the November 19 Pediatrics led by Laura Richardson, MD, MPH, of Seattle Children’s Research Institute.
Serious questions remain about how best to balance screening’s benefits with its potential harms, including false-positive test results, overdiagnosis leading to invasive treatment for non-life-threatening conditions, and repeated exposure to radiation.
hoosing when to start regular breast cancer screening is a complicated decision for individual women and their providers. For most women, increasing age is the biggest risk factor for breast cancer, which is much more common at age 60 than at 40. But two new articles on other risk factors may inform guidelines and clinical practice about screening mammography from age 40 to 49.
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