Decision Aids and the Absence of Expected Longevity Benefits of Mammography Screening in Women 75 Years and Older —Reply

In Reply In their letter about our cluster randomized clinical trial of a mammography screening decision aid (DA) for women 75 years and older, Donzelli and Giudicatti recommended that the DA be more explicit about the lack of data that mammography screening extends life. To inform the DA, we reviewed outcomes from mammography screening trials and from simulation models. A 2016 meta-analysis of mammography screening trials found a 33% reduction in breast cancer mortality with screening for women 60 to 69 years (risk ratio [RR], 0.67 [95% CI, 0.54-0.83]) and a 20% reduction in breast cancer mortality for women 70 to 74 years (RR, 0.80 [95% CI, 0.51-1.28]). This same meta-analysis found no reduction in all-cause mortality for breast cancer screening, but there was a trend for a reduction in all-cause mortality in older women (for women 60 to 69 years [RR, 0.97; 95% CI, 0.90-1.04; I2  = 0%; P = .65] and for women 70 to 74 years [RR, 0.98; 95% CI, 0.86-1.14; I2 = 72.4%; P = .06]). An Australian simulation model found that, out of 1000 women aged 69 years who continued to undergo biennial mammography screening over 10 years compared with 1000 women who stopped scre ening at age 69, 2 fewer women screened died of breast cancer (6 vs 8) and that 2 fewer women screened died overall over 10 years (206 vs 208). Based on these data, our DA states that “physicians are unsure that having a mammogram will lower the chances of dy...
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research

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In this systematic review, researchers highlighted the strengths and weaknesses of existing decision aids for women with an average risk of breast cancer who are eligible for mammographic screening.
Source: CancerNetwork - Category: Cancer & Oncology Authors: Source Type: news
AbstractPurposeTo develop a multiparametric [18F]FDG positron emission tomography/magnetic resonance imaging (PET/MRI) model for breast cancer diagnosis incorporating imaging biomarkers of breast tumors and contralateral healthy breast tissue.MethodsIn this prospective study and retrospective data analysis, 141 patients (mean 57  years) with an imaging abnormality detected on mammography and/or ultrasound (BI-RADS 4/5) underwent combined multiparametric [18F]FDG PET/MRI with PET/computed tomography and multiparametric MRI of the breast at 3  T. Images were evaluated and the following were recorded: for the tumor,...
Source: European Journal of Nuclear Medicine and Molecular Imaging - Category: Nuclear Medicine Source Type: research
DiscussionWe hypothesize that caregivers who receive the decision aid will have lower levels of decisional conflict and higher levels of decision-making self-efficacy compared to the control group. We also hypothesize that the DECAD decision aid will reduce mammography use among older women with ADRD.Trial registrationClinical Trials Register,NCT03282097. Registered on 13 September 2017.
Source: Trials - Category: Research Source Type: clinical trials
The objective of the current article is to present the main challenges for the implementation of the new recommendations for early detection of breast cancer in Brazil, and to reflect on the barriers and the strategies to overcome them. The implementation of evidence-based guidelines is a global challenge, and traditional strategies based only on disseminating their recommendations have proven insufficient for changing prevailing clinical practice. A major challenge for adherence to the new guidelines for early detection of breast cancer in Brazil is the current pattern in the use of mammographic screening in the country, ...
Source: Cadernos de Saude Publica - Category: International Medicine & Public Health Authors: Tags: Cad Saude Publica Source Type: research
Discussion with Experts in the RISIKOLOTSE.DE Project. Geburtshilfe Frauenheilkd. 2018 May;78(5):506-511 Authors: Fürst N, Kiechle M, Strahwald B, Quante AS Abstract Introduction: The mammography screening programme has been the subject of criticism for some time. Invitation to take part is currently based only on the risk factors of age and female sex, whereby women with an above-average risk are screened too seldom and women with a low risk are possibly screened too often. In future, an individualised risk assessment could make a risk-adapted procedure possible in breast cancer screening. In the...
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research
CONCLUSIONS: Implementing risk-based breast cancer screening and prevention will require a multifactorial approach. The transition from theory to practice can be supported by developing evidence-based shared decision aids and family-oriented (genetic) counselling programmes. PMID: 29882455 [PubMed - as supplied by publisher]
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
Siemens (NYSE:SI) Healthineers business said this week it won FDA approval for its Mammomat Revelation mammography system. The newly cleared mammography system includes the company’s InSpect integrated specimen imaging tool and a new HD breast biopsy solution that allows for one-click targeting of suspicious areas, Siemens said. The integrated InSpect tool enables imaging and real-time review of biopsy samples at the device’s workstation. Siemens touted that its HD breast tomosynthesis system allows the widest image acquisition angle at 50 degrees. “Mammomat Revelation is another example of Siem...
Source: Mass Device - Category: Medical Devices Authors: Tags: Food & Drug Administration (FDA) Imaging Oncology Regulatory/Compliance Women's Health Siemens Healthineers Source Type: news
Conclusions/Implications for Practice:Medical care personnel should promote breast cancer screening among Vietnamese women in transnational marriages. The results may be useful in promoting greater awareness among medical care personnel of breast cancer issues and efficacy in performing breast cancer screening for Vietnamese women in transnational marriages and provide references for the establishment of breast cancer prevention and control policies. Background: Breast cancer is a major global health issue. Receiving regular breast cancer screenings aids in the early detection and treatment of breast cancer. Numerous f...
Source: Journal of Nursing Research - Category: Nursing Tags: Original Articles Source Type: research
Conclusion: These data indicate that TBBPA, triclosan, and BPA interact in vivo, consistent with evidence that TBBPA and triclosan inhibit enzymes that are critical for BPA and E2 metabolism. Received: 04 November 2016 Revised: 11 April 2017 Accepted: 13 April 2017 Published: 21 August 2017 Address correspondence to D. deCatanzaro, Dept. of Psychology, Neuroscience &Behaviour, McMaster University, 1280 Main St. West, Hamilton ON L8S 4K1, Canada. Telephone: (905) 525-9140, ext. 23014. Email: Supplemental Material is available online (
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
By Susan Blumenthal, M.D. and Alexandrea Adams The recent commemoration of National Women’s Health Week provided an important time to mark the progress that has been made in advancing women’s health over the past two decades and to highlight what more needs to be done to achieve women’s health equity in America. Historically, women have experienced discrimination in health care despite making 80 percent of health care decisions for their families, using more medical services than men, and suffering greater disability from chronic disease. Before the mid 1990’s, women were often excluded as subjects ...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
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