The Annals of Internal Medicine, on November 17, 2009 disclosed the new recommendations regarding breast cancer screening as described by the Centers for Disease Control (CDC) and Preventive Services Task Force. The recommendations are listed below.
The rating to the right refers to strength of recommendation. Rating is from A-D and I. A= highest recommendation – there’s a high certainty the benefits are substantial; D = lowest recommendation; I = insufficient or conflicting evidence.
No routine screening mammography in women from 40 to 49 years old. Individual risk factors must be taken into account. (C recommendation)
Biennial screening mammography for women aged 50 to 74 years. (B recommendation)
No recommendations for women 75 years or older. (I recommendation)
Breast self-examination (BSE) is unnecessary. (D recommendation)
Clinical breast examination (CBE) is unnecessary in women 40 years or older. (I recommendation)
Digital mammography and magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer are unwarranted. (I recommendation)
These new recommendations were based on numbers. The number that was prevalent in decision time was the “fact” that women younger than 50 account for less than 3% of all breast cancers which renders mammography not cost effective as a screening tool.
The main rumble in this discussion is that it erupted from a number/cost effectiveness perspective only, yet it has spurred many emotional discussions. To me, as a woman’s health advocate, I am inspired by the discussion as it brings tremendous awareness to the difference between what we do by rote, and what we do by choice. It’s one thing that guidelines have recommended women from the age 40 and over to automatically receive mammograms yearly.