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Getting Your Mammogram: What's All the Fuss?

by Dr. Virginia Herrmann

No wonder women are confused.

For years, we have heard how important a yearly mammogram is in the early detection and treatment of breast cancer. Every woman is familiar with the saying that “mammography saves lives.”

This past November, the U.S. Preventive Services Task Force (USPSTF) released recommendations that mammography be done only every other year for women 50 to 74 years old, and none need done for women under the age of 50.

The USPSTF admits screening women aged 50 to 74 years every other year instead of every year will result in a larger number of women who will die from breast cancer. Additionally, not screening women under the age of 50 will result in an increased number of deaths from breast cancer.

Yet the USPSTF justifies its position by stating annual screening harms women because it causes stress and anxiety, especially when women may undergo biopsy for a benign problem. Admittedly, annual mammography comes at the cost of false positive results and perhaps additional procedures.

However, the USPSTF should give women more credit.

Women are appreciative and relieved when a mammogram detects a lesion, especially when the final result is benign.

Interestingly, there were no breast-screening experts on the USPSTF panel, nor any physicians who treat women with breast cancer.

There was immediate outrage and statements issued by the American Cancer Society, the American College of Radiology, the American Society of Breast Surgeons, the American Society of Breast Disease, the American College of Obstetrics &Gynecology, the National Comprehensive Cancer Network and other major medical groups, all opposed the USPSTF guidelines.

What does the data really show? Current guidelines from the above societies recommend annual screening mammography for all women after age 40 and earlier for women whose mother or sister had breast cancer at an early age. In the group most at risk, women between 40 and 49, five women will undergo an additional biopsy procedure for every breast cancer detected.

Annual mammography in this group will reduce breast cancer deaths by at least 15 percent.

And if women between 50 and 74 are only screened every two years as the USPSTF suggests, this will result in disease progression for women who have a breast cancer.

There is plentiful data that earlier detection results in less aggressive treatment and improved survival, not only between ages 40 and 49, but for all women.

The USPSTF makes no recommendation for screening mammography for women age 75 and older. Women in this age group are at the greatest risk for breast cancer, and are at an age when breast cancer is more easily detected by mammography.

In summary, the USPSTF recommendations turn back the clock and if followed will result in breast cancer being detected only when a lump is felt, rather than at its earliest stage.

Do we really believe the increased survival of women is not worth a yearly mammogram?  I don’t think so, and a recent study shows that 99 percent of women believe a false positive mammogram is worth the lives of women who are saved.

So, one good New Year’s resolution for women is to get your screening mammogram. Early detection does save lives.

Reprinted with permission from Bluffton Today


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