Breast cancer is the most frequent female cancers with about 42 000 cases per year. With this women's scourge, organised screening is offered to all women aged 50 to 74. But accession is not up to the challenge...
30% Reduction in breast cancer mortality
The interest of testing is not always well understood. Cancer that is fear, screening is still too often considered as a way to glimpse the possibility of disease, perceived as inevitable. Result, too many patients are still the subject of a late diagnosis. Their chances of recovery would have been well above normal screening and early diagnosis.
Breast cancer, health authorities have implemented a widespread screening of the breast cancer for all women aged 50 to 74. A custom mail is sent to all these women, inviting them to practise a clinical breast examination and mammography. The woman retains the choice of the radiologist from a list of certified specialists and this review is supported 100%. Snapshots are read by a second expert radiologist. A diagnostic assessment is performed in case of anomalies and the attending physician or gynecologist monitors.
The benefit of such a health program is to reduce breast cancer mortality by 25 to 30% if the rate of women's participation reaches at least 70%. And it is currently where the lower pinches, the accession of women being lower than this figure...
Improve adhesion testing
Despite a regular progression, the participation rate remains clearly insufficient, in the order of 40%. A study of the Institute Ipsos, the Institute national cancer has identified the main reluctance of some women:
• "I'm afraid found me cancer..."
It detects breast cancer compared with 6 women detected on 1000. The danger being achieved is therefore low. But above all, a cancer earlier results in lighter treatment and very significantly increases the chance of healing that can achieve 100%;
• "I fear a painful review"
The breast is a triple symbol: femininity, sexuality and maternity. As such, palpation and mammography are experienced with apprehension. As such, health professionals are aware that membership in the program will be all the more easily that women feel comfortable in her first mammogram. In addition, these examinations are not painful and must not constitute a brake testing.
• "I fear that this screening proposes that reviews discount"
Organized screening is still equated with a mass screening, a underscreening, less qualitative and insufficiently custom. There is however nothing because all the elements came together to ensure optimal quality. The organized screening proposes a double reading of clichés, unlike individual screening. Radiologists accredited for this organized screening devices meet strict quality standards. 87% of Radiologists who perform mammograms are participating in this program, therefore, the same practitioners for individual screening. When mammography is positive, an immediate diagnostic assessment is proposed (with new shadow expanded and/or ultrasound).
Breast cancer: self-examination questioned
For many years, doctors encourage women to practise their breasts autopalpations each month. But periodically, the usefulness of such a review is called into question. Doctissimo tries to see a little more clear with Pr Jean-Pierre Daures, president of the campaign for screening for cancer of the breast in the Hérault.
Attention to women's health, early discovery, early treatment, to avoid unnecessary trouble, wish you all be healthy woman.
For many years, doctors encourage the monthly self-examination for women of a certain age. But in late 2001, a group of Canadian task force on preventive health care questioned this practice. Following this announcement, patient associations are the heresy. Who believe?
Between the abandonment and the maintenance, experts are reluctant
Created in 1976, the Canadian task force on preventive health care is far from an eccentric physicians association. It is the body in charge of evaluating the data or the scientific practices to medical examinations, vaccines and preventive care.
For judging the effectiveness and usefulness of the self-examination of the breasts, scientists spent reviewing the results of existing studies. After sorted data that they considered relevant, the authors conclude that, in women aged 40 to 70 years:
• Monthly self-examination has no influence on the reduction of mortality due to breast cancer;
• Women regularly practicing this type of review tend to consult their doctor more frequently and suffer more biopsies.
• Studies detect no difference between the number of malignant tumours in women practicing the self-examination and others;
• Cancers appear to have been detected at the same stage of development among all women.
In less than 40 years or over 70 years, the results are they insufficient to draw conclusions. "In France, there is no official recommendations, but some doctors encourage this practice between two reviews of screening" said the PR. Jean-Pierre Daures, to which these results have nothing revolutionary.
A periodic debate
For several years, the debate on the usefulness of self-examination is periodically on the media scene and sees tear the supporters and opponents. "It is already the woman agrees to periodically perform such a review."
The clinical examination in the rules of the art requires a control in different positions, according to certain techniques much more complicated than we think. "Thus, self-examination can be confused with a powerful clinical examination" said us Pr Daures.
Most of the epidemiological investigations faced an unavoidable ethical dimension: how to compare a group of women followers of these autopalpations to a group to which the study would prohibit any review?
"In the best of cases, the tumor does will be detected if it exceeds 1-1.5 cm in diameter." "For such dimensions, should more talk about screening but early diagnosis" moderate Pr Daures.
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