PANEL OF EXPERTS TOSSES OUT ROUTINE MAMMOGRAMS

In November 2009, a panel of experts formed to provide guidelines on preventative healthcare presented startlingly different mammogram recommendations than those, which American women have been receiving for years.

The recommendation most women receive is, “If you’re 40 or over, have a mammogram every year or two.” Some agencies even go so far as to recommend yearly mammograms. Now, the United States Preventive Services Task Force (USPSTF) recommends that women ages 50 to 74 who are at average risk for getting breast cancer undergo a routine mammogram every two years. And the panel does not recommend mammograms for women under fifty if their risk of breast cancer is normal.

In explaining their recommendation, Dr. Diana Pettiti, vice chair of the committee that issued the recommendations, explained, “When women are screened every other year instead of every year, you see a large reduction in the harms caused by breast cancer and the reduction in breast cancer mortality remains high—between 70 and 99 percent of what you see with annual screening.”

The modification of this guideline will help women avoid some of the downsides of mammograms:

  • Radiation exposure (the same type as that used in a mammogram) is a known risk factor for the development of breast cancer.
  • Mammograms will miss approximately 20 percent of the breast cancers that are present at the time of screening (false-negatives) meaning that the woman is exposed to the radiation and discomfort of the mammogram for no benefit.
  • Some studies show that women have a 30 percent chance of receiving a false positive diagnosis from a mammogram, meaning this original mammogram may be followed by a diagnostic mammogram (more radiation exposure) or ultrasound. One study following 2,400 women over a ten-year period reported an additional 539 mammograms in that period due to positive results. But only 58 mammograms actually identified cancers.
  • When a woman receives a false positive, a study has shown that this false report causes anxiety that may not be dispelled by a correction of the diagnosis. A phone survey of 68 women three months after they received a “suspicious” result from a mammogram showed that one-quarter of them were still worried about the false diagnosis, and that worry was affecting their mood or functioning.

The key to health is finding a competent physician who is not trigger-happy with drugs, radiation and invasive procedures, and working with him or her to develop a sound plan to stay healthy.

Source: National Cancer Institute, Harms of Screening, October 9, 2009, http://www.cancer.gov/cancertopics/pdq/screening/breast/healthprofessional/281.cdr
Source: National Cancer Institute, Independent Task Force Updates Recommendations on Breast Cancer Screening, November 17, 2009,
http://www.cancer.gov/ncicancerbulletin/111709/page2
Source: National Cancer Institute, Mammogram Fact Sheet, August 14, 2009, http://www.cancer.gov/cancertopics/factsheet/Detection/mammograms

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