Wednesday, May 29, 2013

Angelina Jolie doesn't trust medical imaging

Angelina Jolie shocked us all with her decision to remove both her breasts in order to prevent breast cancer. Her breast cancer risk was calculated based on genetics and was 87%. Now it is 5%. I have to agree that this woman is brave! However, I think a very intense screening could have been done with very good results. There are several methods to detect breast cancer: (digital) mammography, tomosynthesis, breast MRI, ultrasound, positron emission tomography and even microwave imaging. Some without any risk, besides the huge amount of money that they cost if we would perform them on every woman. I think money is not a problem for Angelina Jolie and she could get checked out as many times as she wanted...

The following article "Warner, E. (2004). Surveillance of BRCA1 and BRCA2 Mutation Carriers With Magnetic Resonance Imaging, Ultrasound, Mammography, and Clinical Breast Examination JAMA: The Journal of the American Medical Association, 292 (11), 1317-1325 DOI: 10.1001/jama.292.11.1317" refers all these important points:

- "Women with BRCA1 and BRCA2 mutations who do not undergo prophylactic surgery have a lifetime risk of breast cancer of up to 85%, with a significantly higher risk of breast cancer than the general population from age 25 years onward." - This is the case of Angelina Jolie.

- "The combination of MRI, ultrasound, and mammography had a sensitivity of 95%." - great numbers!

- "To date, the reluctance to use breast MRI for surveillance of high-risk women outside the context of a clinical trial relates, to a large extent, to its high cost and relatively low specificity compared with mammography." - This would not be a problem for Angelina Jolie.

- "In conclusion, our results support the position that MRI-based screening is likely to become the cornerstone of breast cancer surveillance for BRCA1 and BRCA2 mutation carriers, but it is necessary to demonstrate that this surveillance tool lowers breast cancer mortality before it can be recommended for general use." - A public figure like Angelina Jolie could help this matter.

And another article "Kriege M, Brekelmans CT, Boetes C, Besnard PE, Zonderland HM, Obdeijn IM, Manoliu RA, Kok T, Peterse H, Tilanus-Linthorst MM, Muller SH, Meijer S, Oosterwijk JC, Beex LV, Tollenaar RA, de Koning HJ, Rutgers EJ, Klijn JG, & Magnetic Resonance Imaging Screening Study Group (2004). Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. The New England journal of medicine, 351 (5), 427-37 PMID: 15282350" states: "In conclusion, our study shows that the screening program we used, especially MRI screening, can detect breast cancer at an early stage in women at risk for breast cancer."


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  2. Hi Pedro. Thanks for your comment. I hope you are enjoying the blog as much as I enjoy writing. All the best

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