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- Page navigation anchor for Canadian Task Force on Preventive Health Care Recommendations on Screening for Breast Cancer in Women Aged 40-74 Years who are not at Increased Risk for Breast Cancer: Author ReplyCanadian Task Force on Preventive Health Care Recommendations on Screening for Breast Cancer in Women Aged 40-74 Years who are not at Increased Risk for Breast Cancer: Author Reply
Scott W. Klarenbach, MD; MSc1; Ainsley E. Moore, MD, MSc2; Brett D. Thombs, PhD3,4; Canadian Task Force on Preventive Health Care5
1Department of Medicine, University of Alberta, Alberta, Canada
2Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
3Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
4Departments of Psychiatry; Epidemiology, Biostatistics, and Occupational Health; Medicine; Psychology; and Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
5Collaborating members of the Canadian Task Force on Preventive Health Care: Ahmed Abou-Setta, Heather Colquhoun, Roland Grad, Stéphane Groulx, Michael Kidd, Tina Korownyk, Eddy Lang, John LeBlanc, Navindra Persaud, Donna Reynolds, John Riva, Guylène Thériault, Brenda Wilson. The complete list of all current members of the Canadian Task Force on Preventive Health Care is available at http://canadiantaskforce.ca/about/members.The Canadian Task Force on Preventive Health Care is an independent body that develops evidence-based guidelines to support primary care providers to deliver the best possible preventive health care to Canadians. It is comprised of experts in primary care, public health, preventive medicine and guideline methodology. The Task Force represents the people of Canada, and not other organizations, such as industry or special inte...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: Recommendations on screening for breast cancer in women aged 40–74 years who are not at increased risk for breast cancerRE: Recommendations on screening for breast cancer in women aged 40–74 years who are not at increased risk for breast cancer
The efficacy of earlier detection of breast cancer by routine screening of women with mammography was clearly demonstrated in several randomized controlled trials (RCTs) conducted in the 1970s-1990s (1). The benefit is understood to come from the ability to treat smaller and/or earlier stage screen-detected cancers, the key words being “earlier” and “treatment”. This is logical – no oncologist, given the choice would opt to treat more advanced disease.
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Randomized trials are held up as the gold standard for quality of evidence. But this is only true if the intervention tested in the RCT is consistent with the current question of interest – i.e. what is the effectiveness of today’s breast cancer screening in women aged 40-74? Although the breast screening RCTs provided proof-of-principle of benefit, the screening techniques available at the end of the last millennium were primitive compared to what is used in screening programs today. Since that time there have been major improvements in both screening and therapy. In particular, the detectability of small invasive cancers has improved markedly.
Data from multiple organized screening programs have demonstrated that women aged 40 and over who avail themselves of screening mammography are from 30-45% less likely to die of breast cancer than their non-screened counterparts, two to three times the mortality reduction seen in the RCTs.(2,3) Much of the increased benefit holds, even after conservative corrections wer...Competing Interests: Martin Yaffe has received a grant and nonfinancial support from GE Healthcare outside the submitted work; is a shareholder in Volpara Health Technologies and Izotropic Corporation; is a member of the scientific advisory committee for Izotropic Corporation; and has a patent pending for a density masking index for mammography. - Page navigation anchor for RE: MammogramsRE: Mammograms
I am 71 yrs old. I was diagnosed with Breast Cancer in my left breast in 2010. which required Chemo and radiation. I have gone every year for my annual screening. I was diagnosed with Breast Cancer in my right breast in 2017 ..because of the mammogram it was caught early and I did not require chemo ..only radiation treatment. thank goodness... I think mammograms are important every year if previous results have shown breast cancer due to estrogen/progesterone not just the BRACA gene.
Competing Interests: None declared.