Considering Breast Cancer Exams for Under 50s Video

Last November, the U.S. Preventative Services Task Force issued a set of recommendations that said many women under 50 might not get much benefit from annual mammograms. Clinicians, breast cancer activists and members of the public were outraged a...
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Considering Breast Cancer Exams for Under 50s Male: On the web and in your hands, this is MDITV. Male: Last November an independent panel of experts causes a ruckus when it released a new set of recommendations but said many women under fifty might not really get much net benefit from annual mammograms. The results set off a blistering reaction, including calls for legislation to require insurance coverage for annual mammograms. What the US preventive services task force said, was the based on all of the latest evidence, women under fifty who don’t have any special risks factors for breast cancer should talk with their doctors about how often they get mammograms. That’s because while mammograms can find some early tumors, the scans aren’t as effective in younger women as they are in older women. And they also exposed women to radiation. As well as follow-up exams, anxiety and even surgery that maybe unnecessary so the task force said, it’s not a slam dunk that the potential benefits of mammography out way the potential harms for every woman under fifty. The panel also confirmed that there’s no reliable evidence that breast self exams save lives. Who are these experts? The US preventive services task force is a collection of private sector experts in prevention and primary care commissioned by a federal agency. They rely on research generated from a dozen evidence based practice centers located throughout the country. The task force issues summaries of medical evidence. It’s up to others to decide whether and how to use that evidence. But many people fear that the report may affect their health care insurance coverage. Doctor Heidi Nelson, the lead investigator of the mammography repot, admits in retrospect that her group could have done a better job explaining what the report was talking about and who would it apply it to. Heidi Nelson: Screening involves a routine test for individuals with no symptoms, no complains, it’s a different thing and I think there’s a confusion early on about what were really talking about here we’re talking about screening not. All the other things, the workups we do when there’s an issue, a change in breast findings. Male: She also notes that the taskforce’s recommendation which was based on her public study was a guide for clinicians and patients and shouldn’t be interpreted as a rule. Heidi Nelson: Well these are called recommendations and the language around them is very friendly to clinicians to make judgment calls. The judgment always trumps a recommendation. And the task force and other professional groups are becoming more, more aware of the role of shared decision making with patients. Male: Patients did in fact stand up and take notice and that’s a good thing for medicine according to Nelson. Heidi Nelson: I think that the public is getting involved in discussions and probably learned a few new terms like over diagnosis and false positives and things that patients need to know about, to make good decisions for them selves so we have lot’s of teach of a moments to get everybody on board and thinking along these lines but it’s never an absolute judgment and patient preferences have a huge role so if we could kind of put that in perspective it looks a little different. It isn’t so threatening. Male: The fewer over mammography recommendations is likely a taste of things to come because of growing interest in what’s known as comparative effectiveness research. Currently most medical research compares a new test or treatment against doing nothing, the so called possible controlled type of trial. On the other hand comparing alternative ways of dealing with a disease or risks can help researchers figure out which option produces the best results. A second step is to then include costs in the calculations. Advocates say that will help us get the best health value for our health care spending. While critics worry about patients being denied coverage, for test or treatments they believe could help th

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