Improving Breast Cancer Care Step by Step

Breast cancer, the most common life-threatening malignancy in the West, is more curable than ever but remains one of the most common causes of cancer death. The cost of this disease is high; so, too, are the costs of treatment because no “magic bullet” cure exists. Yet, the death rate from breast cancer is falling in most Western countries even though the number of cases remains relatively unchanged. This likely reflects increased attention to the details of care.

Because progress against breast cancer is incremental - ie, no single treatment is instantly recognized as dramatically superior – big disparities exist in how various treatments are applied in different countries. Even though science may clearly point to the best way to fight breast cancer, uneven application of new treatments may cause many women to suffer, or even die, unnecessarily.

Although the causes of breast cancer remain unknown, early detection, before cancer cells spread, is crucial. Large randomized trials from several decades ago showed that mammography added to regular physical examination improves early detection, reducing the risk of death. Recent studies focus on the ideal age to begin screening and the ideal frequency of testing. Soon debates about the ideal technology – conventional mammography, digital mammography, ultrasound, magnetic resonance imaging, or a combination of technologies – are likely.

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