Fear of breast cancer strikes terror into the heart of many women. One in nine or ten women will develop breast cancer in the course of her life time. According to recent estimates, 70 to 75 percent of these women will survive five years after diagnosis. Ten years later, only 60 to 63 percent will be alive. This is an improvement of only two to three percent over 1950 survival rates.
However terror is not a good basis for a sound judgment about the best way for an individual woman to detect early breast cancer.
In fact, the best strategy for women is to do all they can to prevent breast cancer before it happens.
"According to some breast cancer experts," writes medical journalist, Ruth Spear in, Women's Health, 1986, "fear of breast cancer is more epidemic than the disease itself... Fear of the disease and its consequences immobilize many women to the point where they avoid breast examinations or delay medical treatment. Fear can be best remedied by concrete knowledge about detection and prevention."
Screening For Breast Cancer
Although 25 percent of the women who get breast cancer fall into a predictable high risk category, the remainder cannot easily be predicted.
One thing is known for sure and that is that the incidence of breast cancer increases with age. Seventy to 80 percent of breast cancer occurs after age 50.
For many years, doctors have been trying to find a screening method that can detect breast cancer early enough and often enough to reduce deaths from breast cancer.
The majority of doctors and researchers are convinced that regular mammography or X-ray examination of breast tissue is that screening method, at least for women 50 years of age and older.
However, that belief may be only partially true. Good physical exam and well taught self exam may be equally important, and may reduce the annual death rate from breast cancer as much as having mammograms every two years, even in the over 50 age group.
A few years ago, Dr. Charles Wright, professor of health care and epidemiology at the University of British Columbia, predicted that although early studies showed some benefit of screening mammograms, later studies would show less and less benefit. He was right.
Dr. Wright believes that the motivation of doctors promoting screening mammography is good. They want desperately to do something to reduce the toll from breast cancer. But he remains unconvinced that screening mammography will accomplish that goal.
How Useful Are Screening Mammograms ?
The best evidence to date shows no reduction in breast cancer death rates from screening mammograms in women aged 40 to 49. For women 50 and older, screening mammograms every two or three years will reduce the annual death rate by a small amount. This varies between 20 percent (or less) and 40 percent.
Skilled physical exam by a physician is an essential component of any breast cancer screening program. The results of the Canadian National Breast Screening Study (NBSS) showed that for women 50 and over regular examination of the breasts by a skilled practitioner alone reduced the annual death rate from breast cancer as much as mammogram exam combined with physical exam.
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