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The great mammogram debate

CTCA

mammogram

Breast cancer screening guidelines can be hard to keep up with. In 2009, a U.S. government task force recommended that women wait until age 50 to begin routine mammograms. The U. S. Preventive Service Task Force, a panel of 16 physician experts, recommended against annual mammograms for women in their 40s who are not at high risk for the cancer, because of the “small” health benefit.

The task force and other more recent research in support of the new guidelines cite data that suggests mammograms put women in their 40s at undue risk, which far outweighs the benefits. These studies show a 50% increase in false-positives when breast detection begins at age 40. Rather than saving lives, the task force says, such screening leads to a domino effect of more x-rays, unnecessary biopsies and surgeries, as well as considerable stress and anxiety.

However, women who discovered their breast cancers early because of routine breast screening, and lived to tell about it, passionately counter that taking away a woman’s right to annual mammograms is what’s stressful—and downright dangerous—for women. They cite some data of their own: that routine mammograms for women ages 40-49 reduces the risk of breast cancer death by 15%. The American Cancer Society and American College of Obstetricians and Gynecologists (ACOG) agree, and have issued statements that they will continue to recommend mammograms beginning at age 40.

The worry is that insurance companies will take their cue from the panel’s recommendations and stop covering the procedure, leaving women to fend for themselves. A study by the Mayo Clinic found preventive mammograms in women in their 40s have dropped 6% since the task force’s recommendation.

While these recommendations are sure to spark debate for years to come, the task force provides some common sense advice that’s good medicine for all of us: Every woman should talk with her physician about when and how often to get mammograms, and decide what’s best for her.

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