The ideal treatment strategy or best diagnostic tool for a disease often changes as new techniques or technologies are developed. The various methods of screening for and diagnosing breast cancer have been no exception over the years, and the recommended modalities will most likely continue to evolve.
Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death in women, making it a significant health concern. Although screening for breast cancer resulted in a decline in breast cancer mortality in the 1990s, controversy remains regarding the value and appropriateness of traditional screening methods. To further complicate the matter, various imaging methods (i.e., digital mammography, magnetic resonance imaging [MRI], and scintimammography) have recently received increased attention for their potential effectiveness in breast cancer screening.
This issue of AFP includes several items that discuss this issue in depth. The article by Doug Knutson, MD, and Elizabeth Steiner, MD, focuses on the current recommendations for breast cancer screening (see page 1660). The authors note that when applying guidelines physicians should assess the individual patient's risk of disease. A related editorial by Russell Harris, MD, MPH examines the current evidence and includes a discussion of the potential harms of screening, such as overdiagnosis and overtreatment (see page 1623). Also included in this issue is a Practice Guideline Brief detailing the latest recommendations of the American Cancer Society on MRI and mammography for breast cancer screening, which were published in the March/April 2007 issue of CA: A Cancer Journal for Clinicians (see page 1715).
Authors' Guide Updates
We have enhanced the Authors' Guide on the AFP Web site (https://www.aafp.org/afp/authors) to make it more user-friendly and convenient for potential authors to submit a manuscript and the accompanying forms. You will find more links to evidence-based medicine resources, author statement and conflict of interest forms, and information on the strength of recommendation taxonomy (SORT). The submission guidelines have also been updated, including information on submitting material for AFP's newest feature, Close-ups, which focuses on the personal side of medicine.
Clinical Quiz Clarification
Several readers (members and nonmembers) have told us that the information on the first page of each issue's Clinical Quiz is confusing. We hope the following explanation helps clarify the guidelines for submitting the Quiz for continuing medical education (CME) credit.
The American Academy of Family Physicians has determined that evidence-based CME (EB CME) is worth additional credit. Several of the routine features in AFP are evidence-based and, therefore, are granted the additional EB CME credit (see https://www.aafp.org/ebcme for more information on EB CME). Any family physician (member or nonmember) seeking CME credit from the Academy will receive double credit for that portion of the quiz designated as EB CME. However, the American Medical Association (AMA) does not increase credit for EB CME. If you apply for AMA Physician's Recognition Award (PRA) Category 1 Credit, the number of credits will be based on the total credit before the EB portion is doubled.
The Academy is both an accrediting agency and an accredited organization (i.e., granting AMA/PRA Category 1 credit to any physician, physician's assistant, and nurse practitioner). Therefore, we are required to provide clarification about both kinds of credit that we offer.
As noted on the first page of the Quiz, AAFP members may take the Clinical Quiz online for credit. Any recipient of AFP (members and nonmember health care professionals) can submit the quiz card from each issue. The Academy's CME department records credit for anyone who submits the cards or takes the quiz online. This record is provided upon request (e-mail: firstname.lastname@example.org). However, nonmembers are responsible for reporting their own CME credits when applying for AMA/PRA Category 1 credit or other certificates or credentials.