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Keep Calm and Follow the Guidelines 

By MJ DeCoteau January 20 2015

I was driving to an appointment yesterday and caught CBC’s resident “house” doctor, Dr. Brian Goldman, speaking on Here and Now about screening tests. He reported that yet another study has been released which says few of the cancer screening tests currently being used actually save lives. I quickly turned up the volume since the mammography screening debate has been a hot topic I’ve followed closely.

Rethink Breast Cancer has taken the lead in Canada in terms of trying to temper the emotional overselling of mammography screening. We are a charitable organization that serves women under 50 and fully supported the 2011 Canadian Task Force on Preventive Health recommendation against routine screening mammography for women ages 40-49 who are of average risk. Rethink Breast Cancer is committed to evidence based health care messages. Dr. Goldman did an excellent job summarizing and explaining the new study; I highly recommend reading his blog post.

In the radio interview, he went into more detail and explains the challenge of “micrometastasis.” It’s a stage of metastasis when the secondary tumors are too small to be clinically detected either by physical exam or imaging techniques. In other words, while we like to think screening mammograms are detecting cancer early enough, it’s not actually early enough for the deadliest forms of the disease. As Dr. Goldman discussed this challenge, I couldn’t help thinking about the recent headlines about Cancer and Bad Luck. Many women, my late mother being one of them, thought they were “lucky” that a screening mammogram caught their breast cancer early but, unfortunately, they were actually part of that “unlucky” group that had aggressive tumours and micrometastases and who ended up not surviving for very long after treatment.

As I said in my blog post about cancer and luck, we all want a sense of control over cancer. We want to be able to do something and not leave our lives up to chance. Both Dr. Goldman and the study had some promising news about new screening techniques, including the National Cancer Institute’s research into a blood test that investigators hope will detect cancer. And, when Gill Deacon asked if women should still bother with mammograms, he pointed out that the paper does not say that screening never saves lives, just that screening has been overrated. He said women should follow the newest guidelines. We agree and you can find them on our website.