Just wanted to comment with information for your readers about the WISDOM study. For the first time in 50 years, we are looking at what is the best way to screen for breast cancer. We deserve better tools than annual mammograms for everyone!
Thank you for the important information. I'd like to know more about the other breast cancer screening modalities, and I'd like to know more about why the HC industry and the insurance industry dismiss those modalities so readily. Ultrasound is used to look at any other area of the body. It seems absurd to use x-ray on breast tissue.
A screening only functions if the patient shows up. Mammograms are a horrible experience with less than stellar accuracy. No one advocates for smashing a scrotum between x-ray plates. Why do we tolerate this?
Excellent question! We have the most data on mammography, as it's been around the longest, and it has proven efficacy. More recent studies have been done looking at ultrasound either as an adjunct to or a replacement for mammography. It is often less uncomfortable and doesn't expose the patient to x-rays. However, ultrasound generally takes longer and also requires more skill and experience on the part of the technician, so both of those things add to its cost and lack of accessibility. Additionally, it has a higher rate of false-positives, meaning that more people will be called back in for additional testing and, potentially, biopsies, who turn out not to have cancer. There can be harms associated with those additional procedures, so we really want as low a false positive rate as we can get. All of this said, researchers are still studying the feasibility of using ultrasound instead of x-ray for breast cancer screening, using new technologies and new classification systems to try to improve test performance. We're likely to hear more about this option in the future. Here's an in-depth article from a few years ago: https://www.sciencedirect.com/science/article/pii/S0887217117301014
Just found this post. Excellent summary!!
Just wanted to comment with information for your readers about the WISDOM study. For the first time in 50 years, we are looking at what is the best way to screen for breast cancer. We deserve better tools than annual mammograms for everyone!
Women 30 and over can find out more at https://www.thewisdomstudy.org/
Thank you for the important information. I'd like to know more about the other breast cancer screening modalities, and I'd like to know more about why the HC industry and the insurance industry dismiss those modalities so readily. Ultrasound is used to look at any other area of the body. It seems absurd to use x-ray on breast tissue.
A screening only functions if the patient shows up. Mammograms are a horrible experience with less than stellar accuracy. No one advocates for smashing a scrotum between x-ray plates. Why do we tolerate this?
Excellent question! We have the most data on mammography, as it's been around the longest, and it has proven efficacy. More recent studies have been done looking at ultrasound either as an adjunct to or a replacement for mammography. It is often less uncomfortable and doesn't expose the patient to x-rays. However, ultrasound generally takes longer and also requires more skill and experience on the part of the technician, so both of those things add to its cost and lack of accessibility. Additionally, it has a higher rate of false-positives, meaning that more people will be called back in for additional testing and, potentially, biopsies, who turn out not to have cancer. There can be harms associated with those additional procedures, so we really want as low a false positive rate as we can get. All of this said, researchers are still studying the feasibility of using ultrasound instead of x-ray for breast cancer screening, using new technologies and new classification systems to try to improve test performance. We're likely to hear more about this option in the future. Here's an in-depth article from a few years ago: https://www.sciencedirect.com/science/article/pii/S0887217117301014