FM JANUARY 2019 - digital edition

The most recent evidence examined
by the Task Force continues to show a
close balance between these potential
benefits and harms.
The Guideline reflects the growing
importance of shared decision-making
between patients and physicians in
preventive health screening, especially
in situations like this where the balance
between potential benefits and harms is
not certain.
Meanwhile, screening is
recommended in women aged 50-74.
The Guideline, developed by the
Task Force, an independent body of
primary care and prevention experts, has
been published in the Canadian Medical
Association Journal (CMAJ).
Other screening modalities
The Task Force recommends not using
magnetic resonance imaging (MRI),
tomosynthesis or ultrasound to screen
for breast cancer in women not at
increased risk. (Strong recommendation;
no evidence)
THERE IS EVIDENCE THAT
PERFORMING BREAST
SELF-EXAMINATION HAS
NO IMPACT ON BREAST
CANCER MORTALITY
We recommend not performing
clinical breast examinations to
screen for breast cancer. (Conditional
recommendation; no evidence)
It recommends not advising women
to practice breast self-examination to
screen for breast cancer. (Conditional
recommendation; low-certainty
evidence)
There was an absence of evidence
on clinical outcomes of screening by
magnetic resonance imaging, ultrasound,
digital breast tomosynthesis or clinical
breast examination, and there was
evidence that performing breast selfexamination
has no impact on breast
cancer mortality.
However, the Task Force noted that
better-quality evidence is needed on the
impact of breast cancer screening for
women of all ages. Additional studies
on Canadian women’s values and
preferences for screening that are based
on accurate estimates of both benefits
and harms, conducted in a transparent
and easily comparable manner, would
help guide future recommendations.
This clinical practice guideline
has been endorsed by the Nurse
Practitioners’ Association of Canada
(NPAC).
The Canadian Task Force on
Preventive Health Care was established
to develop clinical practice guidelines
that support primary care providers
in delivering preventive health care.
The mandate of the Task Force is to
develop and disseminate clinical practice
guidelines for primary and preventive
care, based on a systematic analysis of
scientific evidence.
74 / FUTURE MEDICINE / JANUARY 2019