From Mark Levine, the Doc with Pink Tights
Don’t Shoot the Messenger

Recently, one of the BRIGHT Run supporters emailed us and wanted to know BRIGHT’s position on breast screening (early detection) in young women. She was reacting to a CTV media report from Ottawa (Jan. 17) about recommendations from the Canadian Task Force on Preventive Health Care on Breast Screening.

Among the key recommendations: no routine screening for women aged 40 to 49 and screening with mammography every two to three years for women 50 to 69 years old. It appeared to me that she was indignant because of the recommendation for no screening in younger women.

BRIGHT’s mission is to raise funds for breast cancer research. Although in my blog in the BRIGHT newsletter, I often cover topics related to the treatment and care of breast cancer, it must be recognized that these are my own thoughts. The Juravisnki Cancer Centre and Cancer Care Ontario have recommendations about breast cancer screening and I direct interested readers to their websites.

A number of years ago, I was the Chair of Health Canada’s Committee that developed guidelines (recommendations) on the treatment and care of breast cancer. In any guideline development process, such as the one used by the Canadian Task Force on Preventive Health Care, a very formal process is used to review the medical literature. A thorough literature review is conducted to identify research studies that inform the topic of interest. The studies are categorized according to their quality and strength of the evidence provided. It is very important to make recommendations on the highest quality of evidence available.

The reality is that there is a lack evidence supporting breast screening in women less than 50 years old. Some studies have even suggested that mammography increases breast cancer in this population. A number of respected organizations have published their synthesis of the literature and come up with the same conclusions as the Canadian Task Force. Although we would like early detection to work in young women, it is important that there be proof.

I was troubled by the CTV report. It quoted a radiologist in Ottawa who said that the lives of hundreds of Canadians would be lost if screening was not done in young women. Wow! This statistic is not true.

It’s hard to say why this statement was made, but sometimes physicians have biases to the tools they have available. For example, as a medical oncologist my tool is chemotherapy and radiologists have mammography.

As for CTV, in my view, they were irresponsible, misleading and meant to arouse fear in women. The message here is: “Don’t believe everything you read about medicine. If you aren’t sure, ask your doctor.”