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  #1  
Old 07-18-2011
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Question At what age we should start screening for breast cancer?

At what age do you start routine breast mammogram screening? According to UWorld its 50 and in Kaplan CK Book it says 40...?
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Old 07-18-2011
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I know it is confusing, but in Master the Boards it is says screening for the general population should start at age of 50
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i think 50
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Old 07-18-2011
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Quote:
Originally Posted by aghammoud85 View Post
i think 50
Ok guys let me help you out here ,

1.Breast cancer screening in general ( female) population
should start at the age of 40 every 2 years , than after 50 every 1 year

2. Breast cancer Screening in high risk should start at 35 , yearly

3. The highest Mortality befinit from berast cancer screening comes after the age of 50 .


So if the question says '' when breast cancer screening should be started '' ans is 40
But if the question asks ''At what age the patient will get highest mortality benifit from screening'' than answer 50.


MTB STEP 3.
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but this didnt apply to my uworld question, the question asked what step is appropiate in this girl at age 45 who was coming for a routine checkup who had many risk factors for diabetes (obesity, family history, HTN) and i put mammogram and answer was HbA1C to screen for the diabetes. so technically if routine mammogram should start at 40 wouldnt that answer be ok too. but in explanations it said start routine mammogram at 50

Quote:
Originally Posted by DrAJCH View Post
Ok guys let me help you out here ,

1.Breast cancer screening in general ( female) population
should start at the age of 40 every 2 years , than after 50 every 1 year

2. Breast cancer Screening in high risk should start at 35 , yearly

3. The highest Mortality befinit from berast cancer screening comes after the age of 50 .


So if the question says '' when breast cancer screening should be started '' ans is 40
But if the question asks ''At what age the patient will get highest mortality benifit from screening'' than answer 50.


MTB STEP 3.
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Quote:
Originally Posted by Androide89 View Post
but this didnt apply to my uworld question, the question asked what step is appropiate in this girl at age 45 who was coming for a routine checkup who had many risk factors for diabetes (obesity, family history, HTN) and i put mammogram and answer was HbA1C to screen for the diabetes. so technically if routine mammogram should start at 40 wouldnt that answer be ok too. but in explanations it said start routine mammogram at 50
Yes it could be Mammography as well , but you have to choose the best option , as she is at increased risk of developing IHD , DM , due to her family history so she should get the following screens in order of sequence
1. Serum Total Cholestrol + HLD usually done in women > 45 and in men >35
2.HbA1c or a fasting blood sugar
3. Mammography
4. Pap Smear

I know at times things clash bw Kaplan and Uworld , btw which edition of UWORLD your are studying? or are you doing online UWORLD?

what i used to do in these situations , i used to follow Kaplan.
3.
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Old 07-18-2011
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am doing online
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Old 07-21-2011
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Hello everybody.

Some news... today in medscape... read this link, it says that we must begin at age 40 once a year.

http://www.medscape.com/viewarticle/...4511&src=nldne

;-)
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  #9  
Old 07-21-2011
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Default Evidence based

This is from MTB ,, Conrad Fisher says :

You are required to obtain your preventive medicine information from U.S. Preventive Services Task Force (USPSTF) as an official source for your data.

U.S. Preventive Services Task Force (USPSTF) new recommendations say we should start screening for breast cancer in women at age of 50 years old

N.B: The old recommendation was to start it at age of 40 ,, but that has changed last year.
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  #10  
Old 07-24-2011
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Quote:
Originally Posted by dr-ahmed View Post
This is from MTB ,, Conrad Fisher says :

You are required to obtain your preventive medicine information from U.S. Preventive Services Task Force (USPSTF) as an official source for your data.

U.S. Preventive Services Task Force (USPSTF) new recommendations say we should start screening for breast cancer in women at age of 50 years old

N.B: The old recommendation was to start it at age of 40 ,, but that has changed last year.
Thank you for updating my knowledge
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  #11  
Old 07-24-2011
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Quote:
Originally Posted by Androide89 View Post
am doing online
hey, since you are doing online, can you share the question id here, so that if we've already taken the question, we can see it there. (p.s it's not violation of copyright since you are not posting the question directly)
Thanks!
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i did it like 5 days ago so i dont know the question ID

Quote:
Originally Posted by cool_atomic View Post
hey, since you are doing online, can you share the question id here, so that if we've already taken the question, we can see it there. (p.s it's not violation of copyright since you are not posting the question directly)
Thanks!
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  #13  
Old 07-25-2011
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Mammograms should be performed annually in women over age 50. The lifetime incidence of breast cancer is 1 in 8, with most breast cancer occurring in women over age 50. Mammograms are considered “diagnostic mammograms” if symptoms or signs of breast cancer such as a lump are noted, and “screening mammograms” if no symptoms or signs are found on history or physical.
If the benefits of the exam outweigh the risks and costs, then the exam is performed.
Risk factors for breast cancer include: gender (99% women), age (#1 factor in women), family history (AD – BRCA1, BRCA2, Li-Fraumeni syndrome, Peutz-Jeghers, Cowden’s disease), young age at first menarche (<11 years), old at first pregnancy (>30 years), and late menopause (>50 years). The risk is not increased by fibroadenoma or fibrocystic disease. Breast cancer most often occurs in the upper outer quadrant, known as the tail of Spencer.
It is recommended that women over age 40 have mammograms every 18 months, and annually after age 50. Screening mammograms before age 40 are reserved for women with increased risk factors.
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  #14  
Old 08-16-2011
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Question Mammogram at what age!

Can some of you clear my doubts about these plz....

First absolute time of starting mamograms....is it 40 or 50

2nd....premenpausal woman with lGSIL..whats the next step....
3rd....postmenopausal woman with lgsil...next step

and next step in pre and postmenopausal ASCUS.....


there seems to be a bit of contradictions goin on in uworld and mtb
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Old 08-16-2011
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21years < woman with lGSIL.&ASCUS we do pap every 12 month
>21 years ASCUS we colposcopy and hpv dna and pap every 6 month

>21 years lGSIL we do immediate colposcopy

source 1st aid page 382
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Old 08-16-2011
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Quote:
Originally Posted by miss patho View Post
21years < woman with lGSIL.&ASCUS we do pap every 12 month
>21 years ASCUS we colposcopy and hpv dna and pap every 6 month

>21 years lGSIL we do immediate colposcopy

source 1st aid page 382
i had a question where lGSIL for premenpause you do colpo...while postmenopause you repap 6 to 12 months or hpv testing.....

and whats the absolute age of starting a mamogram...i know the best mortality effect starts at 50..but the starting age is controversial in all of them..some say 40 some say 50
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Quote:
Originally Posted by Kais_MD View Post
i had a question where lGSIL for premenpause you do colpo...while postmenopause you repap 6 to 12 months or hpv testing.....

and whats the absolute age of starting a mamogram...i know the best mortality effect starts at 50..but the starting age is controversial in all of them..some say 40 some say 50
from where this q
about mammogram iam confused about too
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Old 08-16-2011
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Quote:
Originally Posted by Kais_MD View Post
Can some of you clear my doubts about these plz....

First absolute time of starting mamograms....is it 40 or 50

2nd....premenpausal woman with lGSIL..whats the next step....
3rd....postmenopausal woman with lgsil...next step

and next step in pre and postmenopausal ASCUS.....


there seems to be a bit of contradictions goin on in uworld and mtb
The age group for starting mammogram in general population is 40yrs every year annually...

In high risk group compaired to average before 40yrs.
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Quote:
Originally Posted by confident View Post
The age group for starting mammogram in general population is 40yrs every year annually...

In high risk group compaired to average before 40yrs.
MTB says start 50 lol..but i have heard more 40 than 50 so i am gonna disregard MTB..hopefully it doesnt bite me in the ass...
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Old 08-16-2011
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According to kaplan,

if high risk i.e family hx of breast ca ,mammogram, is started at the age of 34 yrs or 10 yrs earlier at which this other relative was diagnosed, which ever cums earlier,....n then annually

n at the age of 40 for normal population ... though maximum benefit cums with mammogram starting at 50....
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  #21  
Old 08-16-2011
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Quote:
Originally Posted by Kais_MD View Post
MTB says start 50 lol..but i have heard more 40 than 50 so i am gonna disregard MTB..hopefully it doesnt bite me in the ass...
in usmleworld it is above 50 for asymptomatic patients
and mamography should be done fr all patients with palpable breast mass above 35 years old
and for any woman with a suspicious mass regardless the age
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Old 08-16-2011
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Quote:
Originally Posted by youssef2310 View Post
in usmleworld it is above 50 for asymptomatic patients
and mamography should be done fr all patients with palpable breast mass above 35 years old
and for any woman with a suspicious mass regardless the age
see this is why its hard to come to a solid begining....i know high risk is 35...best mortality effect is 50....but normal pple is the problem here...i guess i'll go with 40
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Quote:
Originally Posted by Kais_MD View Post
MTB says start 50 lol..but i have heard more 40 than 50 so i am gonna disregard MTB..hopefully it doesnt bite me in the ass...
MTB says that usmle step 2 ck exam needs bottom line answers and are being tested depending on national guidelines pg no 59 mtb.

So MTB says 50 depending on national guidelines says which also says 50....this may be useful http://articles.cnn.com/1999-09-27/h...g?_s=PM:HEALTH

so if its true that exam consider NATIONAL guidelines then we have to go with 50 i think .....
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Quote:
Originally Posted by Kais_MD View Post
see this is why its hard to come to a solid begining....i know high risk is 35...best mortality effect is 50....but normal pple is the problem here...i guess i'll go with 40

yes me 2...!!
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Old 08-16-2011
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Default check this link

Quote:
Originally Posted by Kais_MD View Post
see this is why its hard to come to a solid begining....i know high risk is 35...best mortality effect is 50....but normal pple is the problem here...i guess i'll go with 40
http://www.uspreventiveservicestaskf...f/uspsbrca.htm
it is the main source for answers in usmle world for preventive medicine
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  #26  
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someone post a bottom line to this question.....do we all agree on 50
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Quote:
Originally Posted by Kais_MD View Post
someone post a bottom line to this question.....do we all agree on 50
yup...i think i will go MTB saying exam follows national guidelines( as pg 59) so i am with 50.......
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Quote:
Originally Posted by Kais_MD View Post
someone post a bottom line to this question.....do we all agree on 50
i concur with 50!
Whatever any book says, i'll go with the USPSTF data only because its a uniform national platform for data.
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