Breast cancer screening has generated almost as much controversy over the past few weeks as US President Barack Obama’s Nobel for Peace.
The difference, of course, is that breast cancer screening guidelines have the potential to touch millions at risk of the number one cancer for women. Obama’s Nobel got us a cute speech from the photogenic President.
Fuelling the cancer debate are the findings that low-dose radiation from annual mammography screening can more than double the risk of breast cancer in women with genetic or familial predisposition to the cancer.
The study, presented at the annual conference of the Radiological Society of North America in Chicago this week, suggests the use of alternative screening methods such as ultrasound and MRI, which are currently being done together with mammography to detect tumours and lesions in breast tissue.
The American Cancer Society recommends annual screening with mammography and MRI for women at high risk from the age of 30 years and healthy women at the age of 40. Since India has no country protocols, oncologists usually follow international — particularly US — guidelines.
The new study recommends that young women with a family history of breast cancer should weigh the benefits of mammography against risks from low-dose radiation exposure to understand the issue.
These findings come from peer-reviewed data pooled from six earlier studies that tracked 5,000 high-risk women in the US and Europe. The study reports that women exposed to radiation before age 20 and women with five and more exposures were 2.5 times more likely to develop breast cancer than women who are not exposed at all.
The study comes within weeks of the US Preventive Services Task Force that recommended women begin screening at 50 years, and then every two years, finally stopping entirely at the age of 75 years. Oncologists say 50 years is too late.
Experts worry that the conflicting messages will send out the signal that screening can be delayed, when the reverse is true.
The fact is that breast cancer is the most common cancer among urban women and the second-most common cancer after cervical in India. More than nine out of 10 women diagnosed in the early stages survive, as opposed to one in five at a later stage.
If you are worried about radiation, get your doctor to do a physical exam and when in doubt, get screened using an ultrasound or an MRI.
Radiation risks have always existed, but improved technology is now making it possible to diagnose the disease accurately at 40 per cent lower radiation doses.