Las Vegas NowWhat Should Women Do About The Mammogram Guidelines?

What Should Women Do About The Mammogram Guidelines?

I have seldom seen so much fallout from a health news story. The U.S. Preventive Task Force amazed and angered almost everyone with their pronouncement that routine mammograms before age 50 do not save a significant number of lives. What if you’re the one in 1900 who doesn’t find out she has cancer until it’s too late? 

Of course, complicated reports are never as simple as they seem in the headlines, and that’s the case here, too. A couple of things aren’t well understood. One is that the panel did not say women under 40 never have mammograms.  What they did say is that routine mammograms should not be recommended for women under 50 who have no known risk factors.  Still being debated, but it’s an important difference.

The panel also called attention to the inadequacy of our current diagnostic methods, including mammograms.  The gold standard is not foolproof, and the panel would like to see more research into better ways to find breast cancer, and any cancer. Great idea! 

Dr William Boren of West Valley Imaging called me with some interesting statistics from his own practice. He mentioned that the report brings up the issue of biopsies done unnecessarily. In other words, a mammogram shows a suspicious area, and a biopsy is then done, but turns out negative. No cancer.  At West Valley Imaging, Dr Boren says the percentage of cancers found in women who have biopsies after a suspicious mammogram, is surprisingly close for both groups, over and under 50. For women over fifty, it’s 30%. For women under 50, it’s 26%.

That brings up another important point: a doctor’s skill in reading mammograms has an impact on the number of unnecessary biopsies. Perhaps those standards need to be tightened.  The government has regulations on how many mammograms a radiologist must read, per year, to remain certified.

Dr. Boren also said his practice sees more and more younger women with breast cancer. Of all the positive biopsies for women seen at his practice, 20% are under 50.

I have attached some links to articles on the new study, as well as resources that may help you make an informed decision with your own doctor.

The thinking in 2002: same panel, different members:

http://www.hhs.gov/news/press/2002pres/20020221.html

Who is the U.S. Preventive Services Task Force?

http://www.ahrq.gov/clinic/uspstfab.htm

What Secretary Sebelius said after the panel’s report made news:  http://www.hhs.gov/news/press/2009pres/11/20091118a.html

Some women’s mammograms more difficult to read:

http://news.bbc.co.uk/2/hi/health/3598672.stm

The Cancer Institute’s breast cancer section:

http://www.cancer.gov/cancertopics/types/breast