Barriers to Breast Cancer Screening and Mammograms


Currently, breast cancer is one of the most common cancers in women and one of the chief causes of death worldwide. (Oeffinger,Fontham, Etzioni, et al.)  According to the American Cancer Society 2015, it is the leading contributor to cancer mortality in women aged 40 to 55.  Several risk factors increase the likelihood of the disease occurring.  These factors include: (1) aging, (2) personal history of breast cancer, (3) family history of breast cancer, (4) history of benign breast disease, (5) menarche younger than 12 years, (6) nulliparous, or a first child after age 30, (7) higher education or socioeconomic level, (8) obesity and/or high fats diets, (9) menopause after age 50, (10) lengthy exposure to cyclic estrogen and (11) environment exposure (American Cancer Society, 2015).  The cause of breast cancer is still unspecified, yet these risk factors are known to play a part in the risk of developing this disease.  Essentially all women can be considered at risk.  No successful cure or preventative methods exist, and early recognition offers the best opportunity for decreasing morbidity and mortality.

Literature Review

The first article that I reviewed is titled “Benefits and Harms of Breast Cancer Screening, A Systemic Review”.  According to Myers, et al., mortality from breast cancer has declined substantially since the 1970’s, a drop attributable to both the accessibility of screening methods, particularly mammography, and better-quality treatment of more advanced cancer.  This literature pointed out that, although there has been stable evidence that screening with mammography reduces breast cancer mortality, there are a number of possible harms, including false-positive results, which result in both needless biopsies and added distress and anxiety associated to the potential diagnosis of cancer.  In addition, screening may lead to over diagnosis of cancers that may not have become life-threatening.  With their investigation in the meta-analyses of RTCs (randomized clinical trials) that stratified by age, screening women younger than 50 years was constantly associated with a statistically significant reduction in breast cancer mortality of approximately 15% while screening women 50 years or older was linked with slightly greater mortality reduction (14-23%).  In general, based on their research, they have concluded that “regular screening with mammography in women 40 years or older at average risk of breast cancer reduces breast cancer mortality over at least 13 years of follow-up, but there is uncertainty about the magnitude of this association, particularly in the context of current practice in the United States.”

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