Word: breasts
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...Women's breasts are not the usual topic of public discourse in Washington, at least not outside the context of a scandal. But for the past few weeks, the question of when women should be screened for breast cancer has become the subject of intense medical debate, partisan congressional bickering and a whole lot of confusion among mothers, daughters, sisters and friends, not only inside the Beltway but throughout the rest of the country...
Judging from the reaction to the new breast-cancer recommendations, that is proving to be a difficult reality for Americans to accept. But the task force's mammography advice probably marks the leading edge of similar recommendations to come. Already, new guidelines on Pap smear screening for cervical cancer have delayed the age at which young women should begin regular testing and reduced the frequency of testing in older women. Doctors are also questioning the usefulness of prostate-cancer screening among otherwise healthy middle-aged men, as studies begin to show that the test, which has many risks...
...decade ago, doctors saw breast cancer as a monolithic disease that always progressed the same way, beginning with a single mutant cell that continued to divide and spread to the rest of the body. At the time, screening all women made sense, especially since annual mammograms had reduced deaths from breast cancer 3% each year since 1990. But as Dr. Russell Harris, a professor of medicine at the University of North Carolina at Chapel Hill and a member of the task force, points out, breast cancer occurs less frequently in younger women, and not every cancer is the same. Some...
...impossible to say how frequently such "overdiagnosis" occurs, according to the task force, but the data did conclusively show that in order to save the life of one woman in her 40s from breast cancer, 1,904 women would have to be screened every year for up to 20 years. Because it judged that the risks of harm from annual screening outweighed the benefits, the panel issued its controversial recommendation that most women ages 40 to 49 need not get routine mammograms. "We felt that women would be better served if they understood the trade-off between the benefits, harms...
...effectiveness research, a strategy embraced by both the House and Senate health care reform bills: figuring out which tests and treatments work best--instead of using every available treatment just because it's there--while saving money without adversely affecting health. Using magnetic resonance imaging (MRI) to screen for breast cancer, for example, isn't necessary for the vast majority of women who are at low risk of the disease; because most tumors are not aggressive, most women will not benefit from finding the first signs of tiny tumors that an MRI can detect...