By Sarah A LoBisco, ND
We are already almost through April? Can you believe it? Next week, I’ll be posting my Top Reads which will highlight this month’s most influential newsletters, blogs, and articles on health. Below, are some updates that I wanted to share separately, as I feel they deserve their own spotlight. Specifically, I wanted to provide you with two important updates in women’s cancer screening guidelines for breast and cervical cancer. (My main blog this week can be found at Saratoga.com/living-well where I discuss the link between stress and music, depression and baby blues, and the gut-brain. Read more here).
First, recent research shows that the addition of an ultrasound or MRI with mammography can provide some benefit for women most at risk for cancer, but can create higher false positives for those who aren’t at risk (see below). This research is following the controversial U.S. Preventive Services Task Force (USPSTF) updated recommendation on bi-annual vs. annual mammography screening for breast cancer. (Annals of Internal Medicine. November 17, 2009 vol. 151 no. 10 716-726).
Note: A hot topic in breast health screening is thermography. Some integrative practitioners recommend thermography as an annual screening and believe that is safer and may be more reliable than conventionally accepted methods. Read more about the controversy behind screening and the sensitivity of breast cancer detection here.
Now for the updates:
April 3, 2012 — Annual screening mammography and breast ultrasound exams detect 34% more invasive breast cancers than mammography alone, according to a new multicenter study involving 2662 women with dense breasts and a moderately elevated risk for breast cancer.
Final results of the 3-year American College of Radiology Imaging Network (ACRIN) 6666 study showed that the benefits of screening ultrasound are tempered by more false-positives and negative breast biopsies.
The researchers also found that breast magnetic resonance imaging (MRI) after 3 years of screening mammography and ultrasound raises the diagnostic yield even higher (56% more invasive breast cancers detected), but at the cost of increased false-positives, higher financial expenses, and patient resistance to the procedure.
The study, which is published in the April 4 issue of JAMA, is the first major scientific inquiry to examine the specific, clinical relevance of breast cancers detected with screening ultrasound, principal investigator Wendie A. Berg, MD, PhD, from the Department of Radiology, University of Pittsburgh, Pennsylvania, said to Medscape Medical News.
Source: Ultrasound Adds to Mammography’s Diagnostic Power for At-Risk Women. James Brice. Medscape. 4/3/12.
March 23, 2012 — Screening with magnetic resonance imaging (MRI) can be beneficial in a subgroup of women with a family history of breast cancer. Even though it is very expensive, it could be cost effective for some women with a family history of the disease, even if they lack the BRCA1/2 gene mutation.
Source: MRI Screening for Breast Cancer Is Cost Effective for Some. Roxanne Nelson. Medscape. 3/23/12.
The American Cancer Society (ACS), the American Society for Colposcopy and Cervical Pathology (ASCCP), and the American Society for Clinical Pathology (ASCP) have now published new, evidence-based guidelines that will change how we screen for cervical cancer. To summarize:
Screening should begin at age 21 years. Cytology alone is recommended every 3 years for women 21-29 years of age.
For women 30-65 years of age, cotesting every 5 years is recommended. If HPV testing is not available, cytology alone should be continued every 3 years.
Cytologic findings of atypical squamous cells of undetermined significance (ASCUS) accompanied by HPV-negative results should be managed the same as with a normal screening result.