Mamografias

More than 80 percent of women feel unsafe by the new guidelines which say routine breast cancer screening for women younger than 50 is not mandatory. Instead of recommending yearly mammograms in all women age 40 and above, the U.S. Preventive Services Task Force (USPSTF) told women should not regularly get screened until they reach 50, and those between 50 and 74 should only have mammograms every two years. But at the same time USPSTF didn't say no women younger than 50 should be screened either. They left the decision up to the individual to decide and to consult with their doctors. On the other hand, so many women are over-concerned and overestimate the risk of developing breast cancer, however. Dr. Autumn Davidson and her colleagues handed out questionnaires to 247 women in their 40s who came to the hospital for an annual exam. On average, they considered U.S. Women's lifetime risk of getting the disease at 37 percent. "Indeed, they have been exposed to consistent and high profile media campaigns, endorsed by medicine and variety of interest groups, that have indoctrinated them into the concepts that mammograms lead to early detection and early detection saves lives," the researchers wrote in the American Journal of Obstetrics and Gynecology.

Quando fazer uma mamografia?

For many women, getting a mammogram is already one of life's more stressful experiences. Now, women in their 40s have the added anxiety of trying to figure out if they should even be getting one at all.

A government task force said Monday that most women don't need mammograms in their 40s and should get one every two years starting at 50 - a stunning reversal and a break with the American Cancer Society's long-standing position. What's more, the panel said breast self-exams do no good, and women shouldn't be taught to do them.

For most of the past two decades, the American Cancer Society has been recommending annual mammograms beginning at 40, and it reiterated that position on Monday. "This is one screening test I recommend unequivocally, and would recommend to any woman 40 and over," the society's chief medical officer, Dr. Otis Brawley, said in a statement.

Os computadores substituem os técnicos de saúde

As mulheres devem fazer prevenção quanto á possibilidade de virem a ter cancro da mama. Por isso, devem realizar uma mamografia com uma periodicidade anual.

Na Grã-Bretanha realizou-se um estudo em que se verifica que os técnicos de saúde que analisam as mamografias podem vir a ser substituídos por um computador:

• Computer-aided detection found 198 out of 227 cancers, compared with 199 from double-reading, in the Cancer Research UK study involving 28,000 women.
• NHS breast screening could be made more efficient, say the scientists in the New England Journal of Medicine.
• The national programme screens over 1.7 million each year. The NHS would like to see even more women offered screening by extending eligibility to include the ages 47 to 73. Scanning these extra 200,000 women would increase workload by 30%.
• Professor Stephen Duffy said: "We can now say for certain that this system is as good at detecting breast cancer as the one used as standard practice."

Será que a mais-valia da tecnologia vai afastar também técnicos de saúde, como aconteceu em outros sectores de actividade?

Computadores de apoio à mamografia são ineficazes

Sem os avanços da tecnologia, a qualidade da saúde humana não teria avançado tanto. Contudo, o uso da tecnologia nem sempre é eficaz. Se não vejamos este estudo realizado pelo New England Journal of Medicine, aqui divulgado:

• Computer aided mammogram devices are inaccurate according to the results of a new study to be published in the New England Journal of Medicine.
• The computer devices are used to analyze up to 30% of mammograms that are performed in the United States, and have been found to be less accurate than the results when the test is analyzed by a radiologist, as well as on average costing an additional 70 dollars a test.
• The researchers looked at mammograms from 222,135 women from 1998 to 2002.

O Homem quer sempre mais, mas às vezes querer mais pode tornar-se perverso: The USFDA approved the technology for use back in 1998, and since then more and more mammogram facilities have been adopting the CAD program.

E segundo o referido estudo, a tecnologia suportada por computador pode estar em causa: ``This is a hit for CAD and will surprise many mammographers that thought CAD had done some good,'' said Ferris Hall, professor of radiology at Harvard Medical School and author of an editorial accompanying the study, in an interview. ``It's not the end-all, but a substantial hit. CAD is a big business.''

É preciso estar sempre a estudar e a acompanhar a evolução das novas tecnologias.

Mamografia aos 40?

Há longos anos, que as mulheres são aconselhadas a realizarem mamografias, a partir dos 40 anos. Isto, porque a prevenção na saúde, é a melhor forma de ter melhor saúde e gastar menos recursos.

Um estudo realizado pelo The Lancet, publicado aqui, vem-nos dizer que não é bem assim:

• The Department of Health-backed study, involving 160,000 women, found yearly screening made no impact on breast cancer deaths in this age group.
• In the study, funded by Cancer Research UK, a third of the women received annual screening invitations at the age of 40 and two-thirds only the usual three-yearly screening invite at the age of 50
• From their findings, the researchers estimate screening from age 40 could save four lives for every 10,000 women screened.
• But the benefit of screening women in their 40s needs to be balanced against possible negative considerations. For example screening at younger ages would increase a woman's radiation exposure, which can contribute to breast cancer risk.

É difícil tomar uma decisão sensata, face a estudos realizados em tempos diferentes, com resultados diferentes.