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I had a question-I am a 4th year student currently making up a 3rd year obgyn rotation and I did FP not too long ago and of course their whole message is prevention prevention prevention and I got very familiar with the U.S preventative health task force ( or something like that) but its the basically say all on preventative health and sets the guidelines for screening tests.
Well regarding breast cancer, I was taught and also it is backed up in the USPSTF-here is the exceprt from their breast cancer screening recomendations regarding CBE use for screening
.....
The USPSTF concludes that the evidence is insufficient to recommend for or against routine CBE alone to screen for breast cancer.
Rating: I recommendation.
Rationale: No screening trial has examined the benefits of CBE alone (without accompanying mammography) compared to no screening, and design characteristics limit the generalizability of studies that have examined CBE. The USPSTF could not determine the benefits of CBE alone or the incremental benefit of adding CBE to mammography. The USPSTF therefore could not determine whether potential benefits of routine CBE outweigh the potential harms.
Now I am not arguing one way or another, only curious why every single obgyn I work with does not regard this site has something to listen to (yet follows it for every other cancer screening guidelines!) but FP follow it a lot. Many FPs I know never did breast exams anymore unless the patient asked for it-providing they were getting year mamograms.
I dont think nobody is doubting that by doing clinical breast exams yearly-I am sure you do pick up more masses than had you not-but does picking up the mass equate to any increase in survival of the patient that would not have already been their had you not "caught it" by manual exam?
It is kind of similar to lung cancer-it is obvious that spiral CT used as screenin for lung cancer could undoubtly pick up masses that are smaller than ever picked up by the time they are symptomatic or via CXR yet this is not in place-because a VERY large study showed NO improvment in survival for the patients who had their mass picked up early-the fact is they ended up dying int he same time had they died anyway since the cancer was not curable.
Same thing for breaast-maybe you would pick up a mass a bit earlier but by the time you pick it up by hand-at that size it probably is too late to really affect outcome-
Now sorry this is long but I think its really interesting the views I have heard-I am more the type to like to follow the studies and recomendations based on data-not on old school views.
Well regarding breast cancer, I was taught and also it is backed up in the USPSTF-here is the exceprt from their breast cancer screening recomendations regarding CBE use for screening
.....
The USPSTF concludes that the evidence is insufficient to recommend for or against routine CBE alone to screen for breast cancer.
Rating: I recommendation.
Rationale: No screening trial has examined the benefits of CBE alone (without accompanying mammography) compared to no screening, and design characteristics limit the generalizability of studies that have examined CBE. The USPSTF could not determine the benefits of CBE alone or the incremental benefit of adding CBE to mammography. The USPSTF therefore could not determine whether potential benefits of routine CBE outweigh the potential harms.
Now I am not arguing one way or another, only curious why every single obgyn I work with does not regard this site has something to listen to (yet follows it for every other cancer screening guidelines!) but FP follow it a lot. Many FPs I know never did breast exams anymore unless the patient asked for it-providing they were getting year mamograms.
I dont think nobody is doubting that by doing clinical breast exams yearly-I am sure you do pick up more masses than had you not-but does picking up the mass equate to any increase in survival of the patient that would not have already been their had you not "caught it" by manual exam?
It is kind of similar to lung cancer-it is obvious that spiral CT used as screenin for lung cancer could undoubtly pick up masses that are smaller than ever picked up by the time they are symptomatic or via CXR yet this is not in place-because a VERY large study showed NO improvment in survival for the patients who had their mass picked up early-the fact is they ended up dying int he same time had they died anyway since the cancer was not curable.
Same thing for breaast-maybe you would pick up a mass a bit earlier but by the time you pick it up by hand-at that size it probably is too late to really affect outcome-
Now sorry this is long but I think its really interesting the views I have heard-I am more the type to like to follow the studies and recomendations based on data-not on old school views.