Fewer mammograms for middle-aged women

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In a decision that’s bound to raise eyebrows, especially on the heels of Breast Cancer Awareness Month, the U.S. Preventive Services Task Force is recommending less screening for breast cancer.

Most women should start regular breast cancer screening at age 50, not 40, according to new guidelines released Monday by an influential group that provides guidance to doctors, insurance companies and policy makers.  The new recommendations reverse longstanding guidelines and are aimed at reducing harm from overtreatment, the group says. It also says women age 50 to 74 should have mammograms less frequently — every two years, rather than every year. And it said doctors should stop teaching women to examine their breasts on a regular basis.

via In Reversal, U.S. Guidelines Urge Mammograms at 50, Not 40 – NYTimes.com.

At issue is the question of excess irradiation and high frequency of false positive mammograms in the 40-50 year old age group, which in turn leads to a great deal of testing and anxiety.  The two groups with arguably the greatest financial interest in the status quo, the American Cancer Society and the American College of Radiology, are predictably upset at the announcement.

But the new report conflicts with advice from groups like the American Cancer Society and the American College of Radiology. They are staying with their guidelines advising annual mammograms starting at age 40.

The cancer society, in a statement by Dr. Otis W. Brawley, its chief medical officer, agreed that mammography had risks as well as benefits but, he said, the society’s experts had looked at “virtually all” the task force and additional data and concluded that the benefits of annual mammograms starting at age 40 outweighed the risks.

via In Reversal, U.S. Guidelines Urge Mammograms at 50, Not 40 – NYTimes.com.

Personally, however, I agree with the new USPSTF recommendations.  The excess radiation is not inconsequential, and the rate of false-positive mammograms approaches 8% in the younger women, according to this article from the New England Journal of Medicine.  I’ll be curious to see the reaction of others in the medical community.