That change from annual screening beginning at age 40 is "ill advised and
dangerous," say the American College of Radiology and the Society of Breast
Claiming that the new guidelines will cause "countless unnecessary breast
cancer deaths each year," the groups call for a return to annual screening at
age 40 for average-risk women, and annual screening starting at age 30 (or even
as early as age 25) for higher-risk women.
The USPSTF calculates that the greatest benefit of breast cancer screening
is for women ages 60 to 69. Evidence on women 75 years or older does not exist.
For younger women, the USPSTF calculates that to extend the life of a just one
woman, 1,904 women ages 40 to 49 and 1,339 women ages 50 to 59 must be
That's where the debate begins. A woman's risk of breast cancer starts
rising sharply at age 40. The USPSTF calculates that breast cancer risk gets
large enough by age 50 to justify the "potential harms" of screening.
These harms include anxiety over false-positive results and painful,
unnecessary biopsies. The radiology groups say the risk at age 40 already
justifies any such harm -- and that catching cancer at an earlier stage
prevents the harm of more difficult late-stage treatment.
Because women have been taught for years that breast cancer is most curable
and most easily treated when caught early, the USPSTF guidelines were met with
a public uproar. Health and Human Services Secretary Kathleen Sebelius soon
told women under 50 that the suggested guidelines would not become federal
Now radiologists have officially joined the uproar. Memorial Sloan-Kettering
radiologist Carol H. Lee, MD, chairwoman of the American College of Radiology
Breast Imaging Commission, condemned the USPSTF recommendations as