Mammography: What to Do Now?

The new guidelines, in his view, are encouraging physicians to individualize the screenings.

"Some of this will depend on how risk-adverse a woman is," Baron said. A 40-year-old woman, for instance, might be afraid of radiation from a mammogram and be at average risk for breast cancer. No matter how much a doctor explains that the radiation amount is minimal, he said, she might not be convinced, and she might be advised to wait.

On the other hand, he said, another 40-year-old woman might be very frightened of breast cancer and want the screening. For her, Baron said, he might advise sticking with annual screening.

To women 50 and up, Baron said he would say: "I think it's important to have a mammogram. Whether you want to have it every year or every two years is negotiable."

And for his patients 75 and older? "It's really a matter of individual choice," he said.

The task force has drawn criticism for recommending fewer mammograms and starting them later. But Baron offered another perspective. "I respect them a great deal," he said. "They've got no horse in the race. They are independent experts."

He said the task force did its best to sort through the available evidence and come up with the most scientifically sound guidelines.

Women should also realize that the results of future studies might change the recommendations yet again, Baron said. And no matter what the recommendations are, he said, women must always discuss their own medical history and risks with their doctors when making a decision about screening for breast cancer or any other disease.

The best advice, according to Baron: Know the guidelines. Know your risk. Decide with your health-care professional the best screening schedule for you.

On Wednesday, U.S. Health and Human Services Secretary Kathleen Sebelius issued the following statement on the new screening recommendations:

"There is no question that the U.S. Preventive Services Task Force Recommendations have caused a great deal of confusion and worry among women and their families across this country. I want to address that confusion head on. The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don't determine what services are covered by the federal government."

"There has been debate in this country for years about the age at which routine screening mammograms should begin, and how often they should be given. The Task Force has presented some new evidence for consideration but our policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action."

"What is clear is that there is a great need for more evidence, more research and more scientific innovation to help women prevent, detect and fight breast cancer, the second leading cause of cancer deaths among women."

"My message to women is simple. Mammograms have always been an important lifesaving tool in the fight against breast cancer and they still are today. Keep doing what you have been doing for years -- talk to your doctor about your individual history, ask questions, and make the decision that is right for you," the statement concluded.

More information

The American Cancer Society has more on mammography.

SOURCES: Karla Kerlikowske, M.D., director, Women Veterans Comprehensive Health Care Center, Veterans Affairs Medical Center, San Francisco; Judi Chervenak, M.D., associate clinical professor, obstetrics-gynecology and women's health, Montefiore Medical Center and Albert Einstein College of Medicine, New York City; David Baron, M.D., chief of staff, Santa Monica-UCLA Medical Center and Orthopaedic Hospital, Santa Monica, Calif.; Nov. 18, 2009, news release, Kathleen Sebelius, U.S. Secretary of Health and Human Services

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