Are less mammograms more? American Cancer Society says so.
The new breast cancer guidelines released on October 20 by the American Cancer Society (ACS) have the potential of sparking the biggest breast controversy since Super Bowl XXXVIII. According to the new recommendations, doctors should be getting to second base less often than before – like yours truly, they will press breasts later in life and not as frequently. In addition to discouraging clinical breast exams, the ACS pushed the age in which women should start having mammograms from 40 to 45. The guidelines were published in the Journal of the American Medical Association along with an accompanying editorial.
“Since we last wrote a breast cancer screening guideline, there have been the publication of quite a number of new studies that inform us about the benefits and drawbacks of screening with mammography, so the American Cancer Society commissioned a detailed evidence review by an external expert group to review all of this new data which was then presented to our American Cancer Society guideline committee,” the Society’s Chief Cancer Control Officer Dr. Richard C. Wender said. “That committee then considered all of this evidence over a period of months, did the very difficult job of balancing the benefits and harms, and that’s what led to the change in the guidelines that we’re publishing now.”
In a nutshell – or in this case, in a chest wall – the new guidelines include the following:
· Women with an average risk for breast cancer should begin yearly mammograms at the age of 45 years old.
· The frequency of mammograms should change to one every other year at age 55.
· Women should continue regular mammograms as long as they are in good health.
· As mentioned above, breast examination is no longer recommended – including self-exams – because of a lack of proven benefits.
What does this all mean? For starters, that very special episode of Beverly Hills 902010 where Brenda finds a lump in her breast has finally become obsolete (thankfully we still have the other 292 shows). Seriously though, the ACS made sure to bring home the point that these recommendations are not written in stone. For instance, they noted that women can still start getting mammograms at age 40 if they so choose to, and that women aged 55 can still get mammograms every year if they are so inclined. Moreover, they add that “it’s a good idea to start talking to your health care provider at age 40 about when you should begin screening.”
“We know that debates will continue about the age to start mammography,” Dr. Wender said. “This guideline makes it so clear that all women by age 45 should begin screening – that’s when the benefits substantially outweigh the harms.” However, medical director of the Cancer Prevention Center at the University of Texas M.D. Anderson Cancer Center in Houston Dr. Therese B. Bevers thinks that the guidelines have “the potential to create a lot of confusion amongst women and primary care providers.” Furthermore, President and CEO of the Black Women's Health Imperative Linda Goler Blount wondered on NBCNews.com whether the new recommendations might do a disservice to black women compared to white, seeing how the former are on average 3-7 years younger than the latter when diagnosed. “If we look at this latest set of guidelines in light of what we know about black women and breast cancer, we have to ask how delaying screening and diagnosis is best for black women” Blount said. “These mixed messages could lead to more deaths from breast cancer in our community.”
The United States Preventive Services Task Force sides with the ACS in recommending fewer mammograms - every other year for women ages 50 to 74. On the other hand, both The National Comprehensive Cancer Network and the American College of Obstetricians and Gynecologists recommend start having mammograms at the age of 40 – with the latter recommending starting clinical breast exams at age 19 (by the way, clinic online medical supplies are available here). Not unexpectedly, these mixed signals have “clearly upset countless women who may have been diagnosed with breast cancer before 45,” 13ABC News reports. In order to address these conflicting views, the American Congress of Obstetricians and Gynecologists is calling a meeting on January with the other four groups – kind of like when Don Corleone called a summit with the Five Families – in an attempt to reach a consensus.