DOCTORS RECOMMEND MAMMOGRAMS TO TERMINALLY ILL WOMEN?

NEW YORK (Reuters Health) Jun 30 - Many doctors would recommend mammograms to terminally ill women, even though there is almost no chance they would benefit, according to a U.S. poll.
When and how often to screen for breast cancer with mammography is controversial. But there should be no controversy when it comes to women with terminal illnesses, say the authors of a June 16th paper in Cancer.
That's because those women would have virtually no chance of benefiting from early breast cancer detection, but they would face the risks of mammography screening -- including "false-positive" results that could lead to needless worry and invasive follow-up tests.
There is also the unnecessary cost of having terminally ill women undergo mammograms, at $100 or more.
Yet researchers found that nearly half of U.S. primary care doctors surveyed said they would recommend mammography screening to a hypothetical patient with inoperable lung cancer.
That's despite the fact that the average life expectancy with the disease is about 10 months. What's more, if breast cancer were found in a woman with terminal lung cancer, she would probably not be eligible for treatment.
"We found it very surprising and concerning that so many doctors would recommend screening," said lead researcher Corinne R. Leach, of the American Cancer Society (ACS) in Atlanta.
Leach's team based their findings on a national survey of 1,200 primary care doctors who were presented with several hypothetical patients and asked whether they would recommend mammography screening.
The "patients" were either 50, 65 or 80 years old, and either in good health, diagnosed with heart disease, or in the advanced stages of lung cancer.
Overall, 48% of doctors said they would recommend a screening mammogram to a woman with terminal lung cancer -- though that percentage went down the older the woman was. It also varied by specialty.
Among internists, for example, 32% would recommend a mammogram to a 50-year-old lung cancer patient, while 11% would do so if the woman was 80 years old. Obstetricians/gynecologists were more likely to advise mammograms: 65% would for a 50-year-old with lung cancer, and 37% for an 80-year-old.
A caveat, Leach said, is that doctors were responding to hypothetical scenarios. So the study does not necessarily capture what's happening in actual practice.
Leach said that more studies are needed to see how often screening mammography is actually recommended and performed in terminally ill women.
SOURCE: http://bit.ly/lri9pU