New Mammogram Screening Guidelines FAQ
Why is the USPSTF recommending routine mammograms every two years instead of every year?
Because that's the time frame that looked beneficial to the task force.
Studies showing a reduction in breast cancer deaths associated with
mammography included screening intervals of 12 to 33 months. The evidence
indicated that most of the benefits of screening are maintained when
mammography is performed every two years as opposed to every one, while the
harms are reduced by nearly half.
Kathryn Evers, MD, who directs the mammography program at Philadelphia's Fox
Chase Cancer Center, tells WebMD she will continue to recommend annual
mammograms to her patients.
"The evidence shows that by changing to biannual screening you lose some of
the mortality benefits seen with yearly screening," Evers says.
The new guidelines recommend against breast self-exams and question the benefits of clinical breast exams performed by health care providers. Why?
Two major studies, one from China and another from Russia, found no evidence
that breast self-examinations reduced deaths from breast cancer, but that the
practice leads to additional screening and biopsies.
"The self-exam data were pretty definitive," Pettiti says. "There is high
certainty that there is no benefit, and there are harms which include
unnecessary anxiety from finding something that isn't cancer."
But that doesn't mean a woman should ever ignore a suspicious lump.
"That definitely is not the message," Petitti says. "Anything unusual should
be checked out."
The USPSTF panel concluded the current evidence is insufficient to assess
the risks and benefits of clinical breast exams performed by health care
Evers says she will continue to recommend breast self-exams.
"I don't think the practice is useless," she says. "For many women it is
important because it helps them feel somewhat empowered and in control of their
own breast health."
What should average-risk women in their 40s be doing if mammography and self-exams are no longer recommended?
Although the experts interviewed for this story had different opinions about
whether routine screening is advisable, they all agree that any woman concerned
about breast cancer should discuss her own situation with her doctor or other
health care provider.