jupiterimages
By
Mary Beth Sammons
Everything women have been told about
breast cancer screening seems to have been turned upside down in the last 24 hours following
controversial new guidelines that say women ages 40 to 49 should not get annual screenings.
An influential group's new recommendations about mammograms for younger women sparked a firestorm of controversy since Monday that has left women without clear guidance about how best to protect their health. From
Twitter to the
TODAY Show, women, their loved ones, patient advocacy groups and healthcare providers have been engaged in a furious debate that begs the question: “What should we do now?”
The U.S. Preventive Services Task Force, a government-sponsored taskforce of leading scientists, whose work is closely followed by doctors and insurance companies, is now advising that healthy women in their 40s may not need routine breast screenings. The report states that the benefits of screening before age 50 do not outweigh the risks.
What's more, the panel said in materials published in the
Annals of Internal Medicine, that breast self-exams do no good, and women shouldn't be taught to do them. The new guidelines are for the general population, not those at high risk of breast cancer because of family history or gene mutations. The study called for women ages 50 to 74 to receive breast cancer screening every two years.
“I was absolutely stunned to hear this,” says Leah Siegel, 43, a mother of three children ages one to five from Dallas, who was diagnosed with
Stage Four breast cancer last year, and given a 50-50 prognosis to live two to four years. “Most of the women in my support group discovered they had breast cancer when they found a lump or through a mammogram. They are saying the numbers aren’t high enough to justify this testing. Well, they are high enough for me.”
The new guidelines are gaining strong resistance from medical groups, including the
American Cancer Society, which for more than a decade has urged all women to begin annual mammography at age 40. The ACS also recommends
magnetic resonance imaging, or MRI, every year for women who are at high risk of having breast cancer.
The National Cancer Institute recommends a mammogram every one or two years for women starting at age 40. The
American Medical Association endorses annual screening for women beginning at age 40.
“These unfounded USPSTF recommendations ignore the valid scientific data and place a great many women at risk of dying unnecessarily from a disease that we have made significant headway against over the past 20 years,” says Carol H. Lee, MD and chair of the
American College of Radiology Breast Imaging Commission. Mammography is not a perfect test, but it has unquestionably been shown to save lives -- including in women aged 40-49.”
With breast cancer the second leading cause of death for women in the U.S., the controversial new advice is “very confusing,” says Michael Ziener , Executive Director
Chicagoland Affiliate of Susan G. Komen for the Cure. Ziener, whose mother died of breast cancer, added: “The Komen organization is not advocating any changes in its current recommendations, which say that, women over age 40 with average health risks get annual mammograms as well as those at higher health risks. We’re also stressing that women with high risk factors consult with their primary physicians to help make their decisions. Cancer is personal.”
On the TODAY Show, chief medical editor Nancy Snyderman MD, called the study a “seismic shift,” in breast cancer screening guidelines. “Seismic shifts don’t come often in this country, but this is one of those times. Good science takes what we think we do know and turns it on its head. This is a balance of harms and benefits, with the benefits of screening found not to outweigh the risks. Many women have false positives and unnecessary biopsies, and also being exposed to radiation.”
