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Call it a breast brouhaha: A new study released last week is once again stirring up controversy over mammogram guidelines.
The study, presented Thursday at the annual meeting of the Radiological Society of North America (RSNA), found that annual mammograms beginning at the age of 40 greatly reduce the risk of having a mastectomy in women under 50.
The British study of 971 women between 40 and 50 who had been diagnosed with breast cancer found that those who’d had a mammogram in the previous year cut their chances of a mastectomy in half. Of those who’d received an annual mammogram, 19 percent were treated with a mastectomy. In women who hadn’t been screened with a mammogram, however, 46 percent ended up having a mastectomy.
The results fly in the face of recommendations made last year by the United States Preventive Services Task Force (USPSTF) to change screening guidelines for women with average breast cancer risk from annual mammograms beginning at 40 to every-other-year mammograms starting at age 50. After months of confusion and controversy, they clarified their position to state that while screening shouldn’t be automatic for women in their 40s, they shouldn’t be denied mammograms, either. USPSTF also recommends against breast self-exams, stating that it does not help reduce breast cancer mortality.
Through all this, The American Cancer Society, American Congress of Obstetricians and Gynecologists, and the Susan G. Komen for the Cure breast cancer foundation, as well as other organizations, have maintained their support for yearly mammograms beginning at age 40, and say they refuse to recognize USPSTF’s recommendations.
Another study published in the journal Cancer earlier this year also found benefits to routine mammograms in women between the ages of 40 and 49. Swedish researchers found that breast cancer death rates for that age group fell by 29 percent when women underwent annual mammography.
Though top mammography expert Daniel Kopans, M.D., professor of radiology at Harvard Medical School, said at the time that this study “should end any debate" regarding mammograms for women in their 40s, USPSTF continues to stand by its recommendations.
According to USPSTF, “the net benefit [of annual mammograms] is small for women aged 40 to 49 years.” Their main concerns include emotional trauma from false positives -- which are much more common among younger women who tend to have denser and harder-to-analyze breast tissue -- and the inconvenience and invasiveness of follow-up tests. The other issue is that most women in this age group would be needlessly exposing themselves to yearly doses of radiation.
Still, many experts in the field worry that women will see this as an excuse to skip out on potentially life-saving screenings.
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