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Joint Mammography Statement: Involve Patients

May 5, 2014
Written by: , Filed in: Breast Imaging, Medical Ethics, Practice Management
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Doctors from opposing sides of the mammogram debate have jointly called for more involvement by individual women in decisions about whether they should receive screening mammograms.

At the World Congress on the Menopause, which took place Thursday through Sunday in Cancun, Mexico, Eugenio Paci, MD, of the Institute for the Study and Prevention of Cancer in Florence, Italy, presented findings from the European Screening Network (EUROSCREEN) working group. The findings indicated that mammography screening of 1,000 women saves up to seven lives and results in four cases of overdiagnosis of indolent cancers that would not cause harm.

Robin Bell, MBBS, PhD, on the other hand, presented an analysis that put the overdiagnosis rate at up to 40 percent for invasive cancers found in women invited for mammography screening. Dr. Bell also said screened patients had no fewer deaths compared to unscreened patients. She is deputy director of the Women’s Health Program in the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia.

However, Drs. Paci and Bell issued a joint statement agreeing on the following:

Women and doctors need to move to a new, more inclusive way of communicating the risks and benefit of mammography.

The statement was announced in a news release by the International Menopause Society, which organized the Cancun meeting.

Dr. Paci acknowledged that mammography overdiagnosis is “a potential medical harm.” He added, “We would urge health care providers and doctors to allow women to take more involvement in these important choices: they need to be more involved in the decision-making process, so that if they do go ahead with regular mammography then they can feel comfortable about their decision.”

He also said, “The problem is not really with the screening; it’s what you do when it looks like you have found something suspicious.”

Dr. Bell questioned the practice of routinely inviting women for mammography screening. “If there was no routine invitation for screening,” she said, “then the onus would be on the woman to pursue screening, and she could discuss in detail the pros and cons of screening with her health care provider.”

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Screening mammogram versus diagnostic mammogram under the Affordable Care Act: which should be favored? For details, see our Facebook page.

Related CME seminar (up to 24 AMA PRA Category 1 credits™): Chicago International Breast Course and The Society for the Advancement of Women’s Imaging


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