Breast Cancer Screening Debate
Renee Dudley
Posted Sept 15, 2012
Two Charleston doctors said they would not recommend changes to current
screening practices following Thursday's release of a study that suggested
mammograms might increase cancer risk among a small group of young, high-risk
patients.
Dr. Lisa Baron, chief of mammography at the Charleston Breast Center,
said the European study published in BMJ is too small to draw definitive
conclusions.
"People shouldn't get overly anxious," she said. "The study couldn't
prove a link. They haven't shown a cause and effect, like smoking causes lung
cancer."
Dr. David Ellison of Roper St. Francis Healthcare's Cancer Committee said
it is "not definitive enough to change recommendations."
The study's authors said that "exposure to diagnostic radiation (such as
mammograms and chest X-rays) before age 30 was associated with an increased
breast cancer risk" among carriers of BRCA1 and BRCA2 gene mutations. They
also said, however, that "larger studies are needed to determine whether a
difference does in fact exist," according to BMJ.
The authors, from the Netherlands Cancer Institute, looked at about 2,000
women with the gene mutations in the Netherlands, France and the United
Kingdom between 2006 and 2009. They ultimately recommended non-ionizing
radiation imaging such as MRIs and ultrasounds for the young mutation
carriers.
Baron said that already is what she generally advises for high-risk women
in their 20s.
"We would do an MRI and a clinical breast exam during the year," she
said. "We wouldn't necessarily be doing a mammogram every year. ... We don't
just order tests -- there's a lot of thought that goes into it."
She noted, however, that some insurance carriers require physicians to
perform mammograms before covering MRIs.
Ellison said current accepted recommendations for mutation carriers
involve two screenings a year: a mammogram and an MRI, spaced six months
apart. He said he would not alter those National Comprehensive Cancer Network
recommendations based on the new study.
"At this point, I would recommend continuing with both screenings -- some
imaging every six months," Ellison said.
Reach Renee Dudley at 937-5550 or on Twitter @renee_dudley.
©2012 The Post and Courier (Charleston, S.C.)
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