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Thursday, April 3, 2014

No Cookie Cutter Mammography Decisions

Mammography has never been called a perfect test, but testing in women who are currently not diagnosed with a breast cancer still is thought to save lives. Large studies do not show as much benefit and some potential harms, which patients have not discussed with their gynos recently. So the message to women is not to just get 'cookie cutter' same advice for all, but individualized decisions. For some women the advice is still to begin early and get mammograms yearly. Mammography benefit for those with strong family history of breast cancer or known genetic predisposition is not questioned. Mammography's role in the evaluation of breast pain and breast masses, is not under fire. These are two areas of recommendations that are not being questioned. But after looking at 50 years of research, it has become clear that low risk women may not necessarily benefit from doing years of routine mammograms. And watch for the 'new benefit' to all ACA insurances of free mammography. The follow up, the treatment of non-significant lesions, and the emotional consequences are not necessarily a benefit to the patients and this is the new source of caution and the basis for more weighing pros and cons when it comes to mammography decision making.

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