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Controversial new breast-cancer screening guidelines may change the way American women receive routine preventive care.
The U.S. Preventive Services Task Force, a panel of experts in primary care and prevention, issued guidelines recently recommending that women in their 40s no longer receive annual mammograms. Instead, the group suggests the test be pushed off until age 50, and even then performed only biannually through age 74. According to the USPSTF, the recommendations are intended to decrease the incidence of false alarms and trim the costs associated with extra testing.
The American Cancer Society announced it will disregard the guidelines and continue recommending annual screenings at age 40, particularly for women at high risk for developing breast cancer.
Most cancer experts are following suit, pointing to the life-saving benefits of early mammograms.
“This review confirms mammograms save lives,” said Dr. Peter Garrett, medical director of oncology services for St. Francis Hospital & Health Centers. “One life is saved of 1,904 screened in the under-50 age group. In addition, screening detects earlier cancers which then require less treatment.”
The USPSTF guidelines state:
• Women aged 40 to 49 do not need routine mammograms.
• Women aged 50 to 74 who have an average risk of developing breast cancer should have a mammogram every two years.
• The risks and benefits of mammograms in women 75 and older are unknown.
• Breast exams performed by doctors may not effectively detect breast cancer.
• There is not enough evidence to indicate that women benefit from self-exams.
In light of the USPSTF’s stance on self-exams, the National Cancer Institute encourages women to respond to lumps, bumps or other breast changes they discover on their own, and promptly report concerns to their health care provider.
Cancer care providers fear that if all USPSTF’s guidelines are followed, more women will die from breast cancer.
“Unfortunately, women in their 40s account for 17 percent of breast cancer deaths,” Garrett noted. “St. Francis is not changing its present policy of annual screenings for women in their 40s.”
Should women in their 40s get annual mammograms?
Point: The U.S. Preventive Services Task Force says mammograms performed on women in this age group turn up false positives about 10 percent of the time. These cases can lead to unnecessary anxiety and expensive follow-up tests, biopsies and treatment. As a result, the group is recommending biannual mammograms in women ages 50 to 74.
Counterpoint: The American Cancer Society and the American College of Radiology say mammograms after 40 significantly reduce the number of mastectomies and deaths from breast cancer. Dr. Peter Garrett, medical director of oncology services for St. Francis Hospitals & Health Centers, said, “St. Francis is not changing its present policy of annual screenings for women in their 40s.”
The bottom line: Ultimately, each woman – in conjunction with her health care provider -- should weigh the risks and benefits of receiving routine mammography screenings beginning at age 40.
Posted Nov. 24, 2009
If you have questions regarding the latest mammography recommendations or your own personal health and would like to speak with our Breast Nurse Navigator, please call (317) 782-6704.
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