Healthcare Provider Guidance for Breast Cancer Screening

C l i n M e d International Library Citation: Mayo RC (2017) Healthcare Provider Guidance for Breast Cancer Screening. Int Arch Nurs Health Care 3:060 Received: September 14, 2016: Accepted: January 06, 2017: Published: January 09, 2017 Copyright: © 2017 Mayo RC. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Mayo. Int Arch Nurs Health Care 2017, 3:060


Introduction
The number and variability of recommendations regarding screening mammography for breast cancer detection has undoubtedly left even the most educated patients and primary care physicians in a state of confusion.Unfortunately, confusion often leads to paralysis rather than conviction.In the health care setting it is our role to confidently guide our patients.We are accustomed to making medical decisions on a daily basis in areas without perfect data, and our guidance is especially important with the proliferation of non-medical experts issuing opinions.In this article the most recent recommendations for breast cancer screening from the most relevant groups are summarized in an easy to understand format.Also a few points of analysis and recommendations for patient guidance are discussed.

Short Commentary
All of the consensus recommendations try to balance the benefits of breast cancer screening against itsharms.Table 1 summarizes the recommendations for breast cancer screening from the most influential medical groups.The benefits of breast cancer screening include more early-stage cancers detected, less morbidity with earlier detection, and reduction in cancer-related deaths [1,2].Harms include increased cost, false positive exams (patients recalled for additional testing who do not have cancer), anxiety, and unnecessary biopsies [3,4].Most patients prefer the inconvenience of additional testing to gain the peace of mind that comes from knowing they are likely cancer free.The increasing use of tomosynthesis as a screening tool has the ability to decrease these harms by reducing recall rates, increasing cancer detection rates, and reduce both costs and mortality [5,6].

Organization
Begin and frequency End ACR [14], SBI [15], ACOG [16] 40 of Breast Imaging (SBI), and the American Congress of Obstetricians and Gynecologists (ACOG) seem to approach the issue from an individual patient level by advocating more frequent surveillance.
To reinforce this focus on patients, a new program from the ACR called Imaging 3.0 encourages radiologists to become more visible to patients in order to facilitate patient participation creating patient centered care [9].
Each provider who counsels patient regarding breast cancer screening should be familiar with the published recommendations of various groups in table 1.It is then that provider's duty to discuss the data referenced in this article with each patient in light of their patient specific risk factors.Most patients are unaware that in the USA, 1 in 8 women will develop breast cancer [7].Annual screening diagnoses more cancers that any other timeframe and is associated with an increased overall breast cancer specific survival [9].However nothing comes for free, and in order to achieve additionally detected cancers there will be extra expense and unnecessary testing [3,4].If a healthcare provider recommends against annual screening, they should realize that interval cancers will develop more frequently within their patient population.They should also be prepared to explain their decisions to those patients and their families.
In spite of the controversy and wherever you may fall on the spectrum of screening mammography, patient are best served by unambiguous guidance from their health care providers about when to begin screening for breast cancer.Screening mammography has been proven unequivocally to decrease mortality [10][11][12][13].The harms which sway people away from screening are less quantified.We should all adopt a position and recommend it with conviction to our patients.Our expertise is especially valuable in the setting of multiple conflicting recommendations and the noise created by non-expert advice.

Table 1 :
Summary of breast cancer screening recommendations from various medical groups.