Women deserve clarity from the health-care community on the effectiveness of mammograms and the frequency they should have them. That is why it is distressing to those of us who diagnose and treat breast cancer to have to combat – again – clouded recommendations from the government.
On April 20, the United States Preventive Services Task Force (USPSTF) released a draft “update” to its 2009 recommendations on breast cancer screening. No new developments have occurred since its previous flawed report that caused confusion and controversy.
The USPSTF recommendations still clash with the American Cancer Society, American Congress of Obstetricians and Gynecologists, American College of Radiology and Susan G. Komen for the Cure, all of which recommend annual mammograms starting at age 40.
In its current update, the USPSTF again suggests every-other-year screening mammography for women ages 50 to 74. The USPSTF acknowledges that “evidence shows that mammography screening can be effective for women in their 40s.” However, it still gives screening of women in their 40s a “C” grade, which puts insurance coverage at risk. The Affordable Care Act requires private insurers to cover only exams given a “B” or higher by the USPSTF.
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Let us be clear: Annual mammograms save lives. Period. And they should begin for women at age 40.
Annual mammography is the best early detection tool we have. Mortality rates have dropped by 30 percent since the 1990s, when mammograms became more widely available.
When breast cancer is detected at an early stage, the five-year survival rate is more than 95 percent. If the USPSTF recommendations were followed, about 6,500 additional U.S. women would die each year from breast cancer. In addition, early detection makes simpler and less-invasive treatments a welcome option.
The USPSTF’s approach is seriously flawed. No breast imaging or breast cancer experts were on the panel. In addition, the USPSTF review didn’t include data from more modern studies that take into account improved mammography technology. No actual research was conducted by the task force. Instead, it relied on speculative computer models to estimate mammography benefits by various ages. In contrast, multiple world-wide randomized patient trials have scientifically proven mortality reduction from mammography screening beginning at age 40.
What can you do? Comment on the draft update. Public comments are being accepted through May 18. Visit www.screeningforbreastcancer.org to make your voice heard.
And there’s something even more important you can do. If you’re a woman who’s 40 or older, get your annual mammogram.
Gromet is chief of mammography, Charlotte Radiology. Abinanti is director of women’s imaging, Mecklenburg Radiology Associates.