 One year ago a government panel changed the recommendations for breast cancer screening, from yearly to ever two years. Most professional organizations have disagreed with this and most have not followed suit. The question now being asked is where does this leave women? Should they change what they do, or should they stay with the older, more well entrenched, recommendations and continue to have yearly mammography?
To date experts continue to agree that mammography saves lives. In next year some 209,060 Americans will be diagnosed with breast cancer and 40,230 will die from this disease, according to the American Cancer Society. Hence, all major organizations still recommend regular mammograms. The disagreement comes with at what age women should start and stop, and how frequently mammography should be done
The American Cancer Society, the National Comprehensive Cancer Network, the American Medical Association, the American College of Surgeons and the American College of Obstetricians and Gynecologists all recommend yearly mammograms beginning at age 40.
The U.S. Preventive Services Task Force, however, changed its screening recommendations in late 2009 to suggest that women age 50-74 should be screened every two years, and women 40-49, who are at “average- risk” should discuss when to have mammography with their doctor.
The change in guidelines presented by the U.S. Preventive Services Task Force’s was apparently based on a report which evaluated a number of randomized studies and models of mammography screening. Experts disagreeing with this proposed change in the recommendations state that this change is not consistent with well-accepted survival data, which appear to show that the lowest risk of dying from breast cancer comes when annual screening begins at age 40.
The proposal by the U.S. Preventive Services Task Force’s change mammography guidelines states that one main reason is the “potential harms” associated with mammogram screening. These the Task Force suggests are anxiety, discomfort, radiation risk, the need for women to return for additional imaging and the risk of a biopsy being done when no cancer ends up being found.
While disagreeing experts agree these potential harms do occur, they suggest that in fact call-backs ultimately resulting in unnecessary biopsies are generally uncommon. The state that at worst women screened annually will be called back for additional testing no more often then once every 12-16 years. One opponent of the change in the mammography guidelines stated that the average woman would need to be screened for at least 149 years before she would undergo even one unnecessary biopsy.
Mark Pearlman, M.D. vice chair and professor of obstetrics and gynecology at the University of Michigan Medical School, suggested, “Some potential harms exist, but they should be viewed in context and compared to the harm of not screening. Most women who have routine screening mammography will not need a biopsy.”
Experts also warn that these changes in guidelines could have the unintended consequences of magnifying inequalities in breast cancer survival for African-American women, who are more likely to be diagnosed with breast cancer at a younger age.
Another physician, Lisa Newman, M.D., M.P.H., director of the Breast Care Center at the University of Michigan Comprehensive Cancer Center suggested, “It would clearly be dangerous for adult women to completely discontinue or avoid mammograms because of the confusion created by the screening controversy. The University of Michigan Breast Care Center follows the recommendations of the National Comprehensive Cancer Network for annual mammograms beginning at age 40" She also suggested that women should be encouraged to discuss their individual risk of breast cancer with their physician in order to make the best well-informed decision possible based on their age and circumstance as to when to begin breast cancer screening.
Regardless of any specific organizations guidelines, any lump or change in breast examination should be evaluated immediately, regardless of mammogram history.
No matter what is agreed or what disagreement exists about mamorgraphy, breast self-exam is still a valid procedure, one that you can do on your own and for yourself, to help you, to protect yourself.
For more information on Breast Cancer, click here.
For more information of Breast-Self Examination, click here.
Related Articles:
More articles by this author
|
About Breasts 
