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Tuesday, 6 October 2015

Breast screening recommendations updated for women with Down syndrome

Dr Brian Chicoine is Co-director of the Adult Down Syndrome Centre, in Chicago, with a long-standing reputation as a leader in the health care of adults and adolescents with Down syndrome:

Advocate Physician Leads the Way to Change Mammography Guidelines for Women with Down Syndrome
1st October 2015

During a month that brings greater awareness to the medical conditions of breast cancer and Down syndrome, Chicago area Family Physician, Brian Chicoine, MD, has new research that could change how women with Down syndrome approach mammography screenings.

Dr. Chicoine authored a study recently published in the Journal Intellectual and Developmental Disabilities that questions the utility of mammograms in women with Down syndrome, citing three main reasons.
  • Breast cancer is uncommon in women with Down syndrome. During the 16 years of charts reviewed, less than one percent (0.7%) of the women had breast cancer and none of the cases were invasive breast cancer. In the general population, approximately 12 percent of women will be diagnosed with breast cancer at some point in their lifetime. In fact, most solid tumors are rare in people with Down syndrome.
  • Mammography screening could bring greater harm than benefit. People with Down syndrome are at a higher risk for the adverse effects from the radiation exposure that comes with the diagnostic test. Also, there’s concern for more intense psychological stresses that potentially accompany the screening process.
  • A mammogram is not a cost-effective part of health maintenance for women with Down syndrome.
“We want this evidence-based research to lead to meaningful change for the thousands of adolescents and adults with Down syndrome that we treat and that other doctors across the country treat too,” said Dr. Chicoine, director of the Advocate Medical Group Adult Down Syndrome Center (ADSC).

Dr. Chicoine now recommends the least aggressive approach suggested by government agencies for the general population. He follows Healthcare Quality Research guidelines, which recommends women get their first mammogram at age 50, and then every other year thereafter. The American Cancer Society suggests starting the process at age 40.

Carrie Cebulski, who has Down syndrome, is happy to hear she doesn’t have to return for a mammogram for at least another decade. Her sister and legal guardian, Karen Giardina, is relieved too. Carrie, 41, underwent a mammogram earlier in the year, which resulted in a false-positive reading ... read on

Article Citation:
Brian Chicoine, Melody Roth, Laura Chicoine, and Suela Sulo (2015) Breast Cancer Screening for Women With Down Syndrome: Lessons Learned. Intellectual and Developmental Disabilities: April 2015, Vol. 53, No. 2, pp. 91-99.

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