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Breast Cancer Screening

 A new study from Yale University has raised new questions about the benefits of the newest technological tools used in the breast cancer screening process.

A new study published by Yale University researchers and reported in the journal JAMA Internal Medicine has highlighted a few facts about the efficacy of early breast cancer screening and raises new questions about the benefits of some of the new technological tools used in the screening process. The researchers have found areas in the U.S. that are spending more cash on new screening technologies like digital mammography and are understandably seeing more women diagnosed in the early stages of breast cancer, but they are not seeing any corresponding drops in late-stage breast cancer diagnoses.

The JAMA Internal Medicine report shows the Yale University researchers reviewed a 2006 government Medicare database of more than 137,000 women aged 66 to 100 who had not been diagnosed with breast cancer and found that the nation’s Medicare program had spent over $1 billion on mammography screening that year alone. However, the rates of spending varied depending on where the women lived and different areas spent from just $42 to over $107 per Medicare beneficiary on breast cancer screening. Most of the cost differences were due to differences in the use of newer technologies like digital mammograms and other software tools designed to improve the X-rays’ rate of cancer detection. More disturbing, women that used the most advanced screening methods were 78 percent more likely to be diagnosed with early-stage breast cancer but were not any less likely to be diagnosed with advanced forms of the disease that were more likely to be fatal because they had spread to distant parts of the body.

Several oncologists have said that the results of the Yale study are compelling, but do not fully address the question of whether the extra cash investment in more expensive digital technology actually improves breast cancer outcomes for older women because it didn’t follow the women long enough to determine whether or not spending more on mammography equipment actually reduced real world breast cancer death rates. The research adds to concerns about the increasing numbers of women who were diagnosed with tiny breast malignancies that might never have grown large enough to pose any life-threatening risk at all. Previous studies have shown that for women age 75 and over, there is little evidence that annual mammograms actually lower the risk of dying from breast cancer. That discovery caused a government task force to stop recommending screening for women in that age group back in 2009. For now, most oncologists feel that the results of this latest study call for more assessment in deciding which new technologies should actually be available for cancer screening, and which older patients are the most likely to benefit from them.

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