The Choosing Wisely RI campaign promotes productive conversations between patients and doctor--conversations that research shows produce the right level of care and go a long way towards eliminating tests, procedures and medications that provide, little, if any benefit. The campaign is organized and promoted by the Rhode Island Business Group on Health (RIBGH) and draws on the expertise of the American Board of Internal Medicine Foundation. While we provide materials that enable patients to have informed conversations with their doctors and other health care providers, we do not provide any individual medical advice.
Choosing Wisely provides employees free-of-charge access to online tools developed by ABIMF and their 80+ Specialty Society partners.
The Choosing Wisely Mobile Phone App for Apple and Android phones gives employees the chance to view the Choosing Wisely materials and recommendations on their phones - possibly when they are in their physician's office!
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Imaging and Tumor Marker Tests for Breast Cancer
When you need them- and when you don't
October is Breast Cancer Awareness month. In honor of this observance, we have included Choosing Wisely's recommendations on breast cancer imaging and tumor marker tests, from the American Society of Clinical Oncology.
Imaging tests, such as CT, PET, and bone scans, take pictures to determine if cancer has spread in your body. Tumor marker tests, also known as biomarkers or serum markers, are a type of blood test.
According to the American Society of Clinical Oncology, doctors determine the stage of your cancer by the size, location, and spreading of your tumor. Doctors will also look at your medical history, physical exams, diagnostic tests, and tests of your tumor and lymph nodes to determine your stage.
According to the American Society of Clinical Oncology, early stage breast cancer consists of stages 0, I, II, and IIIA. In stage 0, there are abnormal cells in the breast but they have not broken through the wall of the duct or spread. In stages I, II, and IIIA, there is a tumor that may have spread to lymph nodes under the arm, but not anywhere else. Later-stage breast cancer consists of stages IIIB and IV, where the cancer has spread beyond the breast and lymph nodes under the arm.
What if you have early stage breast cancer?
If you have early-stage breast cancer but no symptoms to suggest the cancer has spread, the American Society of Clinical Oncology recommends to not get an imaging test to look for cancer in other places in your body. Imaging tests expose you to radiation, and the effects of radiation can increase your risk of cancer. According to the American Society of Clinical Oncology, imaging tests can also show a "false positive," which can lead to stress, more tests, and a delay in getting needed treatment. Imagining tests are also costly and not all insurance companies pay for them for early-stage breast cancer.
What if you have already had breast cancer?
According to the American Society of Clinical Oncology, if you have had early stage breast cancer and do not show signs that your cancer has returned, you may not need imaging or tumor marker tests. It is not likely that your cancer has returned and these tests do not usually help you live longer. Such tests can lead to the wrong diagnosis and unneeded treatments. The American Society of Clinical Oncology suggests that the best way to monitor your cancer is to have a mammogram each year, have a physical exam every six months, and watch for symptoms, such as a new lump or pain in the breast.
Do you need tests for later-stage breast cancer?
According to the American Society of Clinical Oncology, if you have later-stage cancer, you should get an imaging test to look for cancer in other parts of your body. Your doctor may also use blood tests to look at tumor markers, but these tests should be done only when it is known that you have advanced cancer.
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