Screening Is Only Part of the Answer to Breast Cancer
Authors: Russell Harris
Journal: Annals of Internal Medicine (2014)

Ideas and Opinions17 June 2014Screening Is Only Part of the Answer to Breast CancerRussell Harris, MD, MPHRussell Harris, MD, MPHFrom Research Center for Excellence in Clinical Preventive Services, Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-0616 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail It is time to reframe our thinking about breast cancer. We need to move away from a primary focus on screening toward the larger issue of reducing the burden of suffering that breast cancer brings to society.This burden is enormous. Almost 300 000 women will be newly diagnosed with breast cancer and 40 000 women will die of it in 2014 (1). Many more live with the label of having been diagnosed, some still having treatment, others wondering whether the cancer will recur. Even more have had a false-positive mammogram. Collectively, throughout the United States, a heightened sense of risk and ...References1. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64:9-29. [PMID: 24399786] CrossrefMedlineGoogle Scholar2. Singer N. Welcome, fans, to the pinking of America. The New York Times. 16 October 2011:BU1. Accessed at www.nytimes.com/2011/10/16/business/in-the-breast-cancer-fight-the-pinking-of-america.html on 25 March 2014. Google Scholar3. Miller AB, Wall C, Baines CJ, Sun P, To T, Narod SA. Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ. 2014;348:g366. [PMID: 24519768] CrossrefMedlineGoogle Scholar4. Kalager M, Adami HO, Bretthauer M, Tamimi RM. Overdiagnosis of invasive breast cancer due to mammography screening: results from the Norwegian screening program. Ann Intern Med. 2012;156:491-9. [PMID: 22473436] LinkGoogle Scholar5. Bleyer A, Welch HG. Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med. 2012;367:1998-2005. [PMID: 23171096] CrossrefMedlineGoogle Scholar6. Esserman L, Alvarado M. Setting a research agenda for ductal carcinoma in situ that meets the current need for change. Ann Intern Med. 2014;:. [PMID: 24566896] LinkGoogle Scholar7. Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L. Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med. 2009;151:727-37. [PMID: 19920273] LinkGoogle Scholar8. Ahn J, Schatzkin A, Lacey JV, Albanes D, Ballard-Barbash R, Adams KF, et al. Adiposity, adult weight change, and postmenopausal breast cancer risk. Arch Intern Med. 2007;167:2091-102. [PMID: 17954804] CrossrefMedlineGoogle Scholar9. Bardia A, Hartmann LC, Vachon CM, Vierkant RA, Wang AH, Olson JE, et al. Recreational physical activity and risk of postmenopausal breast cancer based on hormone receptor status. Arch Intern Med. 2006;166:2478-83. [PMID: 17159013] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Research Center for Excellence in Clinical Preventive Services, Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina.Disclosures: None. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0616.Corresponding Author: Russell Harris, MD, MPH, Sheps Center for Health Services Research, 725 Martin Luther King Boulevard, CB 7590, University of North Carolina, Chapel Hill, NC 27599-7590; e-mail, [email protected]unc.edu.Author Contributions: Conception and design: R. Harris.Analysis and interpretation of the data: R. Harris.Drafting of the article: R. Harris.Critical revision of the article for important intellectual content: R. Harris.Final approval of the article: R. Harris.Statistical expertise: R. Harris.Administrative, technical, or logistic support: R. Harris.Collection and assembly of data: R. Harris.This article was published online first at www.annals.org on 8 April 2014. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByHow the USPSTF's Mammographic Screening Guidelines Should Be InterpretedClinical breast examination screening by trained laywomen in Malawi integrated with other health servicesThe Effect of Treatment Advances on the Mortality Results of Breast Cancer Screening Trials: A Microsimulation ModelJeanette Birnbaum, PhD, MPH, Vijayakrishna K. Gadi, MD, PhD, Elan Markowitz, and Ruth Etzioni, PhDNational Expenditure For False-Positive Mammograms And Breast Cancer Overdiagnoses Estimated At $4 Billion A YearCOUNTERPOINT: Should Lung Cancer Screening by Chest CT Scan Be a Covered Benefit? No 17 June 2014Volume 160, Issue 12Page: 861-863KeywordsBreast cancerCancer risk factorsCancer treatmentMammographyObesityOverweightWeight gain ePublished: 17 June 2014 Issue Published: 17 June 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...