To screen or not to screen: the debate continues...

The purpose of screening for any disease is to pick up the disease at an earlier stage.  It is based on the premise that the earlier a disease is diagnosed, the better the outcome for the individual.  

There is little doubt that the earlier breast cancer is detected, the better the prognosis but many questions remained unanswered:

- How should women be screened for breast cancer? Mammographic screening is expensive and sometimes detects breast cancers that might not cause problems if left untreated.  ie, cancers may may over treated.  Conversely, not all cancers are picked up mammographically.  
Clinical breast screening has it limitations: small breast cancers may not be detected and young women's breasts are difficult to examine.
-Who should be screened?  There is general consensus that women who have a family history should have regular screening.  Many high income countries offer screening to women between the age of 50-70.  Some (the USA) start at the age of 40.
-How often should women be offered screening?  Some countries screen yearly (USA), some every two years (Scandanavia) and other every three years (UK).

At Christiaan Barnard Memorial Hospital, we have started a new project.  Women over the age of 40 who are admitted to the hospital are being offered a free breast examination if they haven't had some form of breast screening in the preceding year.  

Does it work?  We dont know.  To our knowledge, it is the first time a programme like this has been offered.  We are doing it as a pilot project.

if you were being admitted to hospital for a routine operation (eg a hip replacement) would you want a breast examination while you were in hospital?

Please let us have your thoughts.


Fund raising row

Today, four remarkable women will land at Heathrow Airport.  The Coxless Crew are a group of six women who have rowed a boat called Doris 9600 miles from San Francisco to Cairns.  Laura Penhaul, Natalia Cohen and Emma Mitchell rowed the whole distance and 3 others rowed different legs.  They have received a fair amount of coverage in the British press and have been described by the Guardian as a "British female rowing crew".

However, it is not quite accurate.  Lizanne van Vuuren is an osteopath from Cape Town.  She rowed for 97 days and completed the 2nd leg of the journey.  The team blogged about their experiences. In her blog,  Lizanne reflected on the importance of a team:

"Our team worked well because we are all different and we lived by our team values; Strength, Perseverance, Integrity, Resilience, Inspiration and Trust. We supported each other, encouraged and listened. "

Apart from becoming the first crew of four to cross the Pacific Ocean, they were raising funds for two charities: "Walking with the Wounded" and "Breast Cancer Care".  To quote Lizanne:

"In my line of work I have also become intensely aware how privileged most of us are to have a fully functioning body. The charities we are raising money for will be in support of all the ladies whose lives changed overnight, and hopefully will act as a springboard to allow them to gain their independence again."

Any one who has had the diagnosis of breast cancer will be able to relate with what she is saying.

Well done to all the crew but especially to Lizanne who puts Cape Town on the map!