Get ready for a fight.
In a move that certainly came as a surprise to many, new recommendations by a panel published yesterday now recommend that regular mammograms start at 50, not 40 for most women. They also said that women should have mammograms every two years, not every year, from ages 50 to 74. And that breast self-exams may basically be useless.
The recommendations are made in hopes that women will avoid overscreening, unnecessary biopsies and needless anxiety. And it is based in scientific study of when most cancers are found, how aggressive they are, and how successful treatment turns out to be.
But it more likely leaves us conflicted over what it is exactly we’re supposed to do. And it worries some that coverage for annual mammograms for younger women could be dropped by insurance plans.
The American Cancer Society and M.D. Anderson, among others, disagree with the new recommendations.
From the New York Times:
“Just seven years ago, the same group, the United States Preventative Task Force, with different members, recommended that women have mammograms every one to two years starting at age 40. It found too little evidence then to take a stand on breast self-examinations.
“The task force is an independent panel of experts in prevention and primary care appointed by the federal Department of Health and Human Services.
Its new guidelines, which are different from those of some professional and advocacy organizations, are published online in The Annals of Internal Medicine They are likely to touch off yet another round of controversy over the benefits of screening for breast cancer.”
The new guidelines do NOT apply to women with a higher risk of breast cancer, especially those who have had genetic screening for the breast cancer gene. Primarily, the hope is that each woman will discuss with her own doctor the pros and cons of having mammograms before age 50.
“We aren't against screening women in their 40s, we just don't think it should be routine,” said Dr. Diana Petitti, vice chair of the task force. "All we are saying is, at age 40, a woman should make an appointment with her doctor and have a conversation about the benefits and harms of having a mammography now versus waiting to age 50."
From CNN Health:
“While roughly 15 percent of women in their 40s detect breast cancer through mammography, many other women experience false positives, anxiety, and unnecessary biopsies as a result of the test, according to data.
“But the updated guidelines don't come without controversy.
"With its new recommendations, the [task force] is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them," said Dr. Otis Brawley, chief medical officer for the American Cancer Society.”
“The organization says it looked at virtually the same data as the task force but came to a different conclusion. "Breast cancer is a serious health problem facing adult women, and mammography is part of our solution beginning at age 40 for average-risk women," it says. It recommends annual exams beginning at that age.
From The Los Angeles Times:
“Oncologists were nearly uniform in their disparagement of the guidelines, fearing the loss of a valuable cancer-prevention tool. Women in their 40s account for at least a quarter of breast cancer diagnoses.
"I think it is unfortunate that they came to this conclusion," said Dr. Angela Sie, director of imaging at the Breast Center at Long Beach Memorial Hospital. "It would be a huge step backwards for women's health in this country."
“And other groups that issue guidelines about screening and prevention, such as the National Cancer Institute and the American College of Obstetricians and Gynecologists, immediately attacked the federal panel's conclusion, saying that they would not change their guidelines and would continue to urge women to undergo the tests.
“Insurance companies and Medicare administrators, which normally follow the panel's guidelines closely, said they would continue to pay for the procedure -- although it is not clear how long they can resist the panel's influence.”
The New York Times story:
From CNN Health:
From The Los Angeles Times:
What about you?
What are your feelings about these new recommendations? Do you agree that women are having too many mammograms at too young an age? Or do you worry that cancers in those under 50 will go undiagnosed?
We’d love it if you’d share your personal experiences. How old are you, how many mammograms have you had, and how do you feel about yesterday’s panel recommendations?