Apresentação em tema: "J. Abreu de Sousa Clínica de Mama IPO PORTO. Depois de 50 anos, 600.000 mulheres incluídas… 10 Estudos Prospectivos Randomizados, Com 10 anos de follow-up…"— Transcrição da apresentação:
Depois de 50 anos, 600.000 mulheres incluídas… 10 Estudos Prospectivos Randomizados, Com 10 anos de follow-up…
Radiação ionizante Dor Ansiedade Stress ? Riscos
The Real Problem With Mammograms: They're Too Good at Finding Things We Don't Understand by Kate Dailey November 17, 2009Kate Dailey While many women do not think a screening test can be harmful, medical experts say the risks are real. A test can trigger unnecessary further tests, like biopsies, that can create extreme anxiety. And mammograms can find cancers that grow so slowly that they never would be noticed in a womans lifetime, resulting in unnecessary treatment.
When an Ounce of Prevention is Worth a Pound of Harm When NOT to screen for cancer?
Probabilidade de Falsos Positivos na Mamografia, Necessidade de Biópsias e Diagnóstico de Cancro da Mama, em 1000 mulheres que realizaram Mamografia durante 10 anos Taxa de Falsos Positivos : 6,5%
Probabilidade de Cancro da Mama, em 1000 mulheres que realizaram Mamografia durante 10 anos
Rastreio: Detecção de CDIS e Sobre-diagnóstico? Modernas Técnicas de Imagem »» Sobrediagnóstico?
Rastreio de Prevalência: 37% CDIS não progressivos Rastreio de Incidência: 4% CDIS não progressivos Ainda que o sobrediagnóstico seja um elemento a ter a conta no rastreio, o fenómeno tem uma pequena dimensão, tanto em termos relativos como absolutos
BI-RADS 1 <25 Glandular BI-RADS 2 25-50% Glandular BI-RADS 3 51-75% Glandular BI-RADS 4 >75% Glandular CATEGORIAS DE DENSIDADE MAMOGRÁFICA Breast Imaging Report Data System (BI-RADS) American College of Radiology, 4th Edition
Reduzir a Mortalidade 25% Mamografia 2/2 anos dos 50-69 anos
American Cancer Society Guidelines for the Early Detection of Cancer The American Cancer Society recommends these screening guidelines for most adults. Breast cancer Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health Clinical breast exam (CBE) about every 3 years for women in their 20s and 30s and every year for women 40 and over Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s. The American Cancer Society recommends that some women -- because of their family history, a genetic tendency, or certain other factors -- be screened with MRI in addition to mammograms. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests at an earlier age. For more information, call the American Cancer Society and ask for our document,
The Myth of the Mammogram Why many American women are resolutely rejecting the new mammogram recommendations, despite mixed reaction in the medical community. by Pat Wingert November 20, 2009Pat Wingert "We spent 20 years telling women to be afraid, be very afraid, of breast cancer, and that they could save their lives through early detection," says Cindy Pearson, executive director of the National Womens Health Network. But in fact, the evidence has been mounting since 1992, when a Canadian National Breast Cancer Study concluded that mammograms had no effect on mortality for premenopausal women 40 to 50 years old. The initial recommendation to begin mammograms at age 40, made in 1983 by the American Cancer Society, was based on a documented rise in breast-cancer rates, not because of compelling data that mammograms were highly effective for the younger age group.National Womens Health NetworkCanadian National Breast Cancer Study
Panel Urges Mammograms at 50, Not 40 Published: November 16, 2009 Most women should start regular breast cancer screening at age 50, not 40, according to new guidelines released Monday by an influential group that provides guidance to doctors, insurance companies and policy makers.breast cancer The U.S. Preventive Services Task force (USPSTF), funded by the Agency for Healthcare Research and Quality, published its recommendations in Annals of Internal Medicine; its decision was based on an analysis of existing trials that looked at the impact of mammography on breast-cancer deaths. The task force further recommended that women between ages 50 and 74 get screened every two years instead of annually, and that doctors no longer urge women to conduct monthly breast self-exams, since the practice does not appear to significantly reduce the risk of death from breast cancer. Opinião Pública !!!
Valor da Mamografia Sobrestimado ? 40-49 anos Necessário rastrear 1900 mulheres + de 20.000 visitas para mamografia + de 2.000 falso-positivos Para prevenir 1 morte durante 11 anos de follow-up 60-69 anos Necessário rastrear 400 mulheres + de 5.000 visitas para mamografia + de 400 falso-positivos Para prevenir 1 morte durante 11 anos de follow-up 40-49 anos Necessário rastrear 1900 mulheres + de 20.000 visitas para mamografia + de 2.000 falso-positivos Para prevenir 1 morte durante 11 anos de follow-up 60-69 anos Necessário rastrear 400 mulheres + de 5.000 visitas para mamografia + de 400 falso-positivos Para prevenir 1 morte durante 11 anos de follow-up