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Study highlights debate over breast cancer screening guidelines among practitioners

A recent study published in Annals of Internal Medicine suggests that one out of three women who receive treatment for breast cancer based on mammogram results do not need that treatment. According to the researchers behind the study, the tumors detected in these women grew at such a slow rate of speed that they post little health threat.

The study has once again raised the debate over the value of early breast cancer screening, a debate that is reflected in the variable guidelines for cancer screening put out by different organizations. Some of these guidelines recommend that women start receiving mammograms at the age of 40, while others recommend beginning at the age of 50. The frequency of testing varies as well.  

When it comes to breast cancer screening, and cancer screening in general, it is imperative that physicians use discretion and exercise good judgment regarding early screening. Early screening can help ensure that cancer treatment is more effective and less taxing on the patient, but an overly aggressive screening approach can also result in false positives and unnecessary treatment. On the other extreme, however, is the failure to order cancer screening when doing so is the right thing to do.

In the area of cancer screening, especially breast cancer screening, the guidelines are clear enough to determine whether a physician is failing to order appropriate screening, but there is also a range of acceptable professional opinion. Physicians sometimes get into legal troubles when they take an approach that may not necessarily be mainstream, but is still within the range of what is acceptable.

Physicians who are targeted for malpractice due to their cancer screening practices, or for physician discipline over those same practices, can and should work with experienced legal counsel to defend themselves in court and before the state medical board. Even in cases where a physician has acted inappropriately, the zealous advocacy of an experienced attorney can help minimize the effects and long-term consequences of malpractice charges or disciplinary action taken by the state medical board.   

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