11-17-2009, 01:08 PM
I am relieved to hear this. However, no one I heard has mentioned the extra radiation you get from mammograms. I would rather avoid that. Of course, if you have breast cancer in your family, I'm sure your doctor will want you to keep getting these.
New advice: Skip mammograms in 40s, start at 50
Mercury News Staff and Wire reports
Women in their 40s should stop having routine annual mammograms and older women should cut back to one scheduled exam every two years, an influential federal task force announced Monday.
The new recommendations challenge one of the most common medical exams in the fight against breast cancer, and may leave many women questioning the best strategy for detecting the disease. Even Bay Area medical experts are split over the new guidelines.
In making Monday's announcement, the panel that sets government policy on prevention cited evidence that the potential harm to women having annual screenings beginning at age 40 outweighs the benefits.
"We're not saying women shouldn't get screened. Screening does saves lives," said Diana Petitti, vice chairman of the U.S. Preventive Services Task Force, which released the recommendations in a paper being published in today's Annals of Internal Medicine. "But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully."
A review of several major studies and a new statistical analysis showed that mammograms produce false-positive results in about 10 percent of cases, causing anxiety and often prompting women to undergo unnecessary follow-up tests, sometimes disfiguring biopsies and unneeded treatment, including surgery, radiation and chemotherapy.
Women who have a family history of breast cancer or other risk factors
Advertisement
should continue to seek annual screening, doctors said.
The task force's new guidelines, which also recommend against teaching women to do regular self-exams of their breasts and concludes that there is insufficient evidence to continue routine mammograms beyond age 74, immediately triggered intense debate.
Several patient advocacy groups and many breast cancer experts praised the shift, saying it represents a growing recognition that more testing, exams and treatment are not always beneficial.
Yet, the American Cancer Society, the American College of Radiology and other experts condemned the change, saying the benefits of routine mammography have been clearly demonstrated and play a key role in reducing the number of mastectomies and the death toll from one of the most common cancers.
Reaction in the Bay Area was mixed. The nation's internists recommended the same change in 2007, in a report led by Dr. Douglas Owens, a health policy expert and researcher with the Veterans Affairs Palo Alto Health Care System and Stanford University.
He applauded Monday's news, saying "the guidelines are evidence-based, and are very similar to ours. There is growing recognition of some modest but potential harm that needs to be weighed with modest benefits of using mammograms in younger women," he said.
Doctors at the University of California-San Francisco will likely shift their advice, said Dr. Shelley Hwang, chief of breast surgery at UCSF's Breast Cancer Center, where she focuses on the early detection of breast cancer.
"It is probably not a routine test that should be used in every woman in this younger age group," said UCSF's Hwang. "It is in line with what we've observed with our own patients, which is that the incidence of breast cancer among women between 40 and 50 is so low that you have to screen so many women to save one life."
At the San Francisco-based patient advocacy group Breast Cancer Action, deputy Director Joyce Bichler said, "We are delighted that they're raising this issue. We have been concerned about routine screening for years now."
"The benefit of mammography has been totally oversold. What the task force is recommending may confuse women, but we hope they'll be able to look at the evidence and discuss it with their doctor, to make the right decision."
Physicians at El Camino Hospital in Mountain View, however, will continue to recommend annual screening starting at age 40.
"We think that the benefits of mammography far outweigh the risks,'' said radiologist Imtiaz Qureshi, chief of radiology at El Camino Hospital in Mountain View. "While screening tests have their flaws, mammography remains the only test that offers some screening value."
New advice: Skip mammograms in 40s, start at 50
Mercury News Staff and Wire reports
Women in their 40s should stop having routine annual mammograms and older women should cut back to one scheduled exam every two years, an influential federal task force announced Monday.
The new recommendations challenge one of the most common medical exams in the fight against breast cancer, and may leave many women questioning the best strategy for detecting the disease. Even Bay Area medical experts are split over the new guidelines.
In making Monday's announcement, the panel that sets government policy on prevention cited evidence that the potential harm to women having annual screenings beginning at age 40 outweighs the benefits.
"We're not saying women shouldn't get screened. Screening does saves lives," said Diana Petitti, vice chairman of the U.S. Preventive Services Task Force, which released the recommendations in a paper being published in today's Annals of Internal Medicine. "But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully."
A review of several major studies and a new statistical analysis showed that mammograms produce false-positive results in about 10 percent of cases, causing anxiety and often prompting women to undergo unnecessary follow-up tests, sometimes disfiguring biopsies and unneeded treatment, including surgery, radiation and chemotherapy.
Women who have a family history of breast cancer or other risk factors
Advertisement
should continue to seek annual screening, doctors said.
The task force's new guidelines, which also recommend against teaching women to do regular self-exams of their breasts and concludes that there is insufficient evidence to continue routine mammograms beyond age 74, immediately triggered intense debate.
Several patient advocacy groups and many breast cancer experts praised the shift, saying it represents a growing recognition that more testing, exams and treatment are not always beneficial.
Yet, the American Cancer Society, the American College of Radiology and other experts condemned the change, saying the benefits of routine mammography have been clearly demonstrated and play a key role in reducing the number of mastectomies and the death toll from one of the most common cancers.
Reaction in the Bay Area was mixed. The nation's internists recommended the same change in 2007, in a report led by Dr. Douglas Owens, a health policy expert and researcher with the Veterans Affairs Palo Alto Health Care System and Stanford University.
He applauded Monday's news, saying "the guidelines are evidence-based, and are very similar to ours. There is growing recognition of some modest but potential harm that needs to be weighed with modest benefits of using mammograms in younger women," he said.
Doctors at the University of California-San Francisco will likely shift their advice, said Dr. Shelley Hwang, chief of breast surgery at UCSF's Breast Cancer Center, where she focuses on the early detection of breast cancer.
"It is probably not a routine test that should be used in every woman in this younger age group," said UCSF's Hwang. "It is in line with what we've observed with our own patients, which is that the incidence of breast cancer among women between 40 and 50 is so low that you have to screen so many women to save one life."
At the San Francisco-based patient advocacy group Breast Cancer Action, deputy Director Joyce Bichler said, "We are delighted that they're raising this issue. We have been concerned about routine screening for years now."
"The benefit of mammography has been totally oversold. What the task force is recommending may confuse women, but we hope they'll be able to look at the evidence and discuss it with their doctor, to make the right decision."
Physicians at El Camino Hospital in Mountain View, however, will continue to recommend annual screening starting at age 40.
"We think that the benefits of mammography far outweigh the risks,'' said radiologist Imtiaz Qureshi, chief of radiology at El Camino Hospital in Mountain View. "While screening tests have their flaws, mammography remains the only test that offers some screening value."