If you're among the millions of women concerned about the new guidelines on mammogram screenings from the United States Preventive Services Task Force (USPSTF), well, join the club. It's no wonder we're alarmed, given the conflicting responses from reputable medical organizations like the American Cancer Society, as well as health insurers and government policymakers.
"If there's one thing women should take away from all this, it's that no one disagrees with the fact that fewer women die from breast cancer because of mammograms, and no one is saying women shouldn't get mammograms," says Therese Bevers, MD, medical director of Cancer Prevention at M.D. Anderson Cancer Center. "The debate is over the potential downside of mammograms, and how that affects how frequently women should get them."
What do these recommendations mean for you and your health? We sifted through the research and spoke to top experts to help explain.
What are the new rules for getting mammograms?
After commissioning two studies that reviewed the risks and benefits of breast cancer screening, the USPSTF announced changes to the current mammogram guidelines, which the same group instituted in 2002. For average-risk women, they recommend:
No routine mammograms for women ages 40 to 49
Every-other-year mammograms for women ages 50 to 74
No need for clinicians to teach women to do breast self-exams
The task force concluded there is not enough evidence to recommend for or against mammograms in women 75 and older. The same goes for breast exams performed by doctors (clinical breast exams) for women of all ages. None of these guidelines apply to women at increased breast cancer risk due to genetic mutations or those who have a history of chest radiation.
Why did this government task force announce new mammogram guidelines?
First, it's important to know something about the group that issued the guidelines. The USPSTF is a government-appointed committee of scientists whose job it is to impartially interpret available scientific evidence to make recommendations for a number of health issues, like the benefit of vaccines or heart disease prevention.
"Their guidance is about 'just the facts, ma'am' with as little overlay of judgment and interpretation as possible," says Prevention advisor David Katz, MD, director of the Prevention Research Center, Yale University School of Medicine.
The group's goal: to determine the ideal breast cancer-screening schedule based on what would save the most lives while causing the fewest side effects.
"When you look strictly at the data, it's very clear mammograms should start at age 50 and be given every other year," says breast cancer surgeon Susan Love, MD.
The reason is that, based on the findings, giving mammograms to women every other year from ages 50 to 69 reduces breast cancer deaths by 16.5 percent over a lifetime. If screening is started at age 40 and continued every other year, there's a 19.5 percent lifetime reduction in deaths from breast cancer. That 3 percent difference translates roughly to saving one woman's life for every 1,000 who are screened but also causing hundreds of false positive results (when an abnormality is detected that isn't really cancer) and dozens of unnecessary biopsies.
The Task Force paper says that while mammograms save lives, "the additional benefit gained by screening at age 40 years rather than at age 50 years is small, and that moderate harms from screening remain at any age."
"We're not trying to give women whiplash, but we've become more realistic about what mammograms can and can't do," says Love. "Medicine is an ongoing process; we tend to present things as the truth when, really, they're the best guess of the moment."
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