Breast cancer screening: Can you put a price tag on saving a life?

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Published February 12, 2014


Yearly mammograms in middle-age women do not reduce breast cancer deaths, according to a new study published in the British Medical Journal, that questions the need for annual screening.

Previous direction from the American Cancer Society, recommended women to get a mammogram every year, starting at age 40; but the cost of this kind of care is quite high, so in 2009, a U.S. task force made a recommendation that this population be screened every other year instead.

The biggest criticism of doing yearly mammograms is the chance for a false-positive result which can lead to unnecessary treatment and further damage.

Another study, published in Annals of Internal Medicine, found that a mammogram every other year is acceptable and safe, and would translate to $7 billion in savings for our health care system.

But can you really put a price tag on saving someone’s life?

When breast cancer spreads, the cost of metastasis is about $250,000 per person/year. Doctors have long advocated screening; whether it’s mammograms for women or PSA screening for men.

When breast cancer is caught early due to sensitive screening, the 5-year survival rate is as high as 98 percent.

So in order to save money and save lives, the answer may lie in tailoring the screening process to each individual patient is key; so doctors must take into account risk factors and family history/genetics.

So what is suggested?

Doctors suggest screening every year as a starting point. By looking at the patient’s screening results, we can evaluate a patient’s risk factors and decide whether or not she should continue screening every year or go on a biannual schedule.

Women with dense breast tissue are harder to follow, so doctors may need to follow the trend in patients’ cases individually. If a patient has an abnormal mammogram, her doctor can then decide to either do a second mammogram or a biopsy.

But no matter what the task force recommends or what studies may suggest, the best thing a patient can do is take the time to do self exams, educate herself and find a doctor she trusts.

Remember: As I tell my patients; not every elevated PSA needs a biopsy, and not every biopsy needs a surgery. The same goes for mammography screening and treatment.