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To Mammogram or Not to Mammogram? A note on recent studies

A Canadian medical research study has recently been published questioning the value of doing screening mammograms on women in their forties. The article has spurred controversy because the results contradict multiple other similar research studies which showed that women in that age group who get regular mammograms actually are spared death from breast cancer more often that women who are not invited to screening.

Some problems with the methods of Canadian study, published in the journal BMJ, were pointed out by a scientist at the University of Washington, Judith Malmgren, who has worked with Swedish Medical Center doctors to see how women in their forties have fared in our system. Click here to read Dr. Malmgren’s letter to the editor of BMJ.

There are two ironic features to the Canadian study. First, the authors say it is okay for women to not get screening starting in their forties “when adjuvant therapy for breast cancer is readily available.” This means that it is okay to diagnose breast cancer later because you can mop up bigger and more advanced cancers with treatment like chemotherapy, radiation and bigger surgery. But at Swedish, we do not think that many women prefer more severe therapy rather than earlier detection.

Secondly ...

Parent's guide to newborn testing, screening, and prevention measures

When picturing the first days of an infant’s life, what we look forward to the most is love. We express our love in so many ways: skin-to-skin, breastfeeding, swaddling and snuggling. 
 
Love also means keeping them safe. 
 
Advances in maternal-infant health are one of the greatest success stories of the 20th century, with a drop in the death rate of 99%. But some of those dangers only stay in the past through constant vigilance. Behind every screening test and preventive measure is a careful, research-driven rationale. Here are seven newborn tests, screenings, and prevention measures you should know about:
 
Vitamin K injection 
Vitamin K is vital for blood to clot properly. Newborns cannot make Vitamin K and it is poorly transferred in breast milk. Without this injection, babies are at risk for spontaneous bleeding from the umbilical cord, mucus membranes, even in the brain. Giving Vitamin K has greatly reduced this "hemorrhagic disease of the newborn," but rates are increasing as more parents refuse it. Oral Vitamin K has not been shown to prevent this potentially devastating disease. 
 
Hepatitis B vaccine
This is an anti-cancer vaccine. Before this vaccine existed, approximately 10,000 kids under age 10 contracted hepatitis B each year. Most had no known exposure to it. Kids are more likely than adults to get very sick and to have complications. Vaccination at birth has greatly reduced rates of pediatric liver cancer due to hepatitis B. 
 
Antibiotic eye ointment
This prevents bacterial eye infections. Some of these infections are associated with sexually transmitted bacteria, but not all of them are. Negative testing or a monogamous relationship does not ...

5 things to know about cancer screenings

Cancer causes 580,000 deaths a year in the United States. One in eight women will develop breast cancer and one in six men will be diagnosed with prostate cancer during their lifetimes. However, many deaths can be prevented when cancer is detected at an early stage. Cancer screening and risk assessment tests are the tools we use to find cancers early.
 
How do we find early cancers?

Some cancer screenings can be done yourself at home at essentially no cost or risk. This includes regular self-examination of the breasts, testicles and skin. Home fecal occult blood testing can also be done to screen for colorectal cancer. Additional information on cancer screening and self-examinations can be found on websites such as www.cancer.org or www.webmd.com.

 
Other screening requires medical interventions. There is good evidence that well-targeted screening saves lives. However, screening tests such as mammography, colonoscopy and prostate-specific antigen (PSA) are  ...

Neck lump or mass

A palpable neck lump in any patient should raise some concern.  In the case of a pediatric patient, the concern may be less, since reactive and infectious nodes in the neck can be fairly common in children.  When a child has a bad episode of pharyngitis, tonsillitis (sore throat), or even a bad cold, the lymph nodes of the neck may react and become enlarged.  In that type of scenario, your doctor should prescribe appropriate antibiotics to resolve the enlarged lymph nodes and follow up to make sure that the nodes have regressed.

Very few pediatric neck masses will end up being concerning.  Besides infectious neck lymph nodes as stated above, some of the other more common causes of pediatric neck mass are congenital cysts.  However, none of the pediatric neck masses should be ignored.  A neck lump that persists for more than a few days should be looked at by a pediatrician.

In the adult population, a neck mass or lump can be much more concerning.  Essentially when an adult patient presents to us with a neck mass, we have to fine the root cause and basically rule out a tumor.  Of course, infectious lymph nodes do happen in the adult patients as well, but it is less common.  Congenital cysts are also much less common in the adult patient. 

The more common causes of a neck mass in the adult patient are ....

What’s New in Lung Cancer Screening?

For too long lung cancer has been detected too late to benefit from the most effective treatments.  Screening for lung cancer with Low Dose CT (LDCT) has been shown in large research trials to reverse this trend.  There is now cause for optimism that screening has the potential to change the negative statistics around lung cancer.

The current reality is that lung cancer related deaths in our country has surpassed those of prostate, breast, and colon cancers combined.  Although smokers are not the only people at risk for lung cancer they are at much higher risk than the average population.  In fact, if they have a smoking history of 1 pack per day for 30 years or more, are actively smoking or have quit in the last 15 years and are now 55 years old or older, they are considered in a higher risk group for developing lung cancer and would benefit from being screened to detect lung cancer early and at a treatable state.

The last decade has been pivotal in ....

What do parathyroid glands do?

Our parathyroid glands are four tiny glands that lie in our neck, just to the sides of our thyroid gland. When normal, they are the size of a grain of rice or a small flat bean.

These glands control calcium balance in our bodies. They do this by producing a hormone named parathyroid hormone (PTH). PTH acts on our bones, kidneys, and gut to keep the right amount of calcium in the right places.

When one or more of these glands become abnormal, they produce too much of this hormone (PTH). This can cause our bones to...

Breast Cancer Screening Recommendations Revisited

Are you confused about breast cancer screening recommendations? If you are, you are not alone.

Multiple organizations have come out with conflicting studies, data, and recommendations. Those advocating for reduced screening argue that screening does not improve the death rate from breast cancer; that women who have biopsies that are found to be benign suffer significant psychological harm; and that cancers are found that would never cause death.

Significant flaws have been found in these arguments by physicians who have committed their careers to understanding and treating breast cancer. There are multiple problems with the scientific methodology, assumptions, endpoints and analyses used in these critiques of mammogram screening recommendations. One problem is that medical science currently does not have the ability to distinguish between lethal cancers and those that will not cause death. Based on rigorous scientific data, we do know that the best way to improve survival from breast cancer is to detect it before it becomes clinically obvious and to treat it early.

None of the major oncology organizations support the guidelines calling for reduced screening. A letter to the New England Journal of Medicine ....

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