UAB Synopsis, Vol. 29, No. 03, January 20, 2010
UAB Comprehensive Cancer Center (CCC) experts advise women to stick to the American Cancer Society’s recommendation that all women should get annual mammograms starting at age 40 years. This recommendation comes in the wake of controversy and confusion surrounding new guidelines issued by a federal advisory board.
The US Preventive Services Task Force (USPSTF) in November 2009 recommended that women no longer undergo routine mammography before age 50 years and that women between 50 and 74 years be screened every other year. Women at increased risk for breast cancer should continue annual screening, the task force said.
Read the task force’s full statement here.
CCC Director Edward E. Partridge, MD, strongly urges women to have routine mammograms at age 40 years. Breast cancer is the second-leading cause of cancer death in US women, and widespread mammography and treatment advances have significantly reduced mortality in recent years.
Dr. Partridge is president-elect of the American Cancer Society national board. “There is no disagreement that mammography saves lives,” he says, “the controversy is over evaluating the risks and benefits.”
The benefits are clear. A body of convincing evidence indicates that screening with mammography reduces breast cancer mortality, particularly among older women (those aged 60 to 69 years).
The harms the task force cited in making its new recommendations result from unnecessary imaging tests and biopsies and anxiety and inconvenience related to false-positive screening results. The task force also noted the issue of overdiagnosis (harms associated with treatment of cancer that would not become clinically apparent during a person’s lifetime).
Dr. Partridge points out that none of the risks of mammography will harm a person’s physical health. “The risk from radiation, for example, is so small that it does not come into the question.”
Helen Krontiras, MD, codirector of the UAB Breast Health Center, agrees. “Mammography is the best screening tool we have right now,” she says. “It’s designed to find breast cancer early, when it’s treatable and curable.
“There has been a lot of research in the area of screening mammography, and a lot of data have been generated that indicate we can save lives with screening mammography. As a result of that data we will continue to recommend annual mammography beginning at the age of 40.”
In addition to screening mammography, CCC experts continue to recommend self breast examinations, which the USPSTF no longer recommends. “It’s not so much the technique that is important but the awareness of changes in the breast. Women who note changes in the breast should bring these changes to the attention of their doctor,” Dr. Krontiras says.
You can hear Dr. Krontiras discuss the USPSTF statement here.