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Panel: Screening Mammogram Guidelines Change

U.S. Preventive Services Task Force Recommends Routine Mammography Screening Every 2 Years

Mammography Screening Every 2 Years continued...

According to the risk-assessment model, about 60% more false-positive results could be expected for every 1,000 mammograms performed when screening is started at age 40 instead of 50.

Jeanne S. Mandelblatt, MD, MPH, of Georgetown Lombardi Comprehensive Cancer Center led the research team that developed the model.

The team concluded that mammogram screening every two years achieves most of the benefits of annual screening with far fewer false-positives and other negative outcomes.

"Mammogram screening clearly has benefits, but there are potential risks as well," she tells WebMD. "Women need to discuss their own individual balance of risks and benefits with their health care providers."

Brawley: ‘Women Want Mammograms’

The American Cancer Society’s Brawley says surveys show women understand the limitations of mammography but still place a high value on breast cancer screening.

“With its new recommendations, the USPSTF is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them,” he notes.

In 2003, an ACS expert panel reviewed much of the same research as the USPSTF panel but came to very different conclusions about who should be screened and how often, ACS volunteer president Elizabeth T.H. Fontham, MD, tells WebMD.

She worries the competing recommendations will confuse women and keep those who most need mammograms from getting them.

“It would be a terrible thing if women conclude that mammography screening is not useful,” she says. “One thing we know for sure is that mammography saves lives. That is true for women in their 40s, for women 75 and older, and for all women in between.”

Fox Chase Cancer Center Director of Mammography Kathryn Evers, MD, tells WebMD she will continue to recommend annual screening to her patients in their 40s and to healthy patients who are 75 and older.

She is concerned that health insurance providers may deny coverage for routine mammogram screening to average-risk women younger than 50 and older than 74, based on the new USPTF recommendations.

“Mammography is not a perfect tool, but it saves lives,” she says. “Right now it is the best tool we have to prevent deaths from breast cancer, and women want their insurance to pay for it.”

In a joint statement emailed to WebMD, the American College of Radiology (ACR) and the Society of Breast Imaging say the new guidelines could cost women's lives.

Calling the guidelines a "cost-cutting" measure, the ACR states that "two decades of decline in breast cancer mortality could be reversed and countless American women may die needlessly from breast cancer each year."

In the statement, Carol H. Lee, MD, chairwoman of the ACR's Breast Imaging Commission, calls the USPSTF recommendations "unfounded." Lee adds, "Mammography is not a perfect test, but it has unquestionably been shown to save lives -- including in women aged 40-49."


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