Regina Lohr, Oncology Roundtable
A recent Michigan Breast Oncology Quality Initiative (MiBOQI) study found frequent overuse of advanced diagnostic imaging (PET, CT, and radionuclide bone scans) among women with early stage breast cancer at low risk for spreading. The findings shed light on a prime opportunity for reducing imaging overutilization—and increasing value in cancer care.
Specifically, researchers found that from 1998 to 2009, more than 25% of such patients underwent these tests even though use of advanced diagnostic imaging in these cases was contrary to published guidelines.
Big opportunity to dial back imaging for early breast cancer patients, study finds
Brian Clement, Oncology Roundtable
A recent study published in Nature confirms that there are four genetically distinct types of breast cancer. Hundreds of researchers with The Cancer Genome Atlas network analyzed samples from 825 patients, discovering findings that hold major implications for the future of cancer research and drug development.
Study confirms four types of breast cancer
My colleagues in Technology Insights just reported on yet another conflicting study on mammography that I wanted to share:
A new study published in the British Medical Journal is reigniting the debate over mammography as a screening tool. Lead author Dr. Phillipe Autier looked at historical data from 1980 to 2006 to determine the impact of screening mammography on breast cancer-related mortality in six European countries. The greatest decrease in mortality over this 26 year period was seen in women ages 40 to 49. However, there was not a correlation between decreases in mortality and the availability of screening mammography in these countries. Accordingly, the authors have concluded that there is no impact on breast cancer mortality as a result of screening mammography. Rather, the authors infer that improved treatments for breast cancer and efficiencies in healthcare are more likely responsible for this decrease.
This and other studies published on the efficacy of screening mammography seem at odds with new recommendations from the American College of Obstetrics and Gynecology (ACOG). This week, ACOG released updated guidelines recommending screening mammography annually for all women over 40. ACOG revised its earlier recommendations of annual screening at 50 due to new evidence that more aggressive tumors have shorter sojourn times (time from detection to symptoms) in women under 50, and that reductions in mortality due to screening are similar for women in their 40s and 50s. ACOG emphasizes the importance of communicating the risk of false positives to women receiving screening mammography as this risk increases with more frequent imaging. This high false positive rate is also referenced in the widely-discussed USPSTF guidelines from 2009 that recommend biennial screening at age 50.
New Studies Conflict with Established Guidelines Over Effectiveness of Screening Mammography