BREAST CANCER SCREENING GUIDELINES from Overlake Hospital
By Steven E. Scallon, MD, Medical Director, Overlake’s Breast Health Centers
Over the past 30 years, we’ve made major strides in the battle against breast cancer. These strides came up against a major hurdle this past year when the U.S. Preventive Services Task Force (USPSTF) changed its recommendations and stated women aged 40 to 49 should not undergo routine mammography screening, and those aged 50 and older should only be screened every other year. Many leading health care experts and organizations, however, continue to advise women to get annual clinical breast exams and screening mammograms starting at age 40, and state that the USPSTF’s recommendations ignore existing clinical evidence.
At Overlake Breast Health Center, we continue to urge women ages 40 and older to maintain their annual mammography screening schedule. What I’ve been sharing with my patients is that the American Cancer Society and the American College of Radiology continue to recommend annual clinical breast exams and screening mammograms starting at age 40. In addition, most insurance companies continue to cover mammography screening starting at age 40.
The American Cancer Society (ACS) believes that a commitment to early detection with regular breast screening exams starting at age 40 provides the best chance for survival. Multiple large clinical studies have shown that regular mammography screening significantly decreases breast cancer deaths in women ages 40 to 74.
Unfortunately, the USPSTF used its own computer models, not actual cancer patient cases, to come to its conclusion that the risks of screening—anxiety over false positive results, biopsies and the possibility of overtreatment of breast cancers—does not justify the number of lives saved by screening in the 40 to 49 age group.
Another issue of concern to the medical community is that the task force recommendations would eventually be accepted by insurance companies and take away each woman’s right to make her own decisions about mammography screening.
The USPSTF is an independent panel of primary-care clinicians, including internal medicine and family practice physicians, pediatricians, nurses, OB/GYNs and behavioral health specialists, designed to provide recommendations for health-care providers and health systems. Major insurers, including the Centers for Medicare and Medicaid services, also look to the task force to make decisions about coverage for preventive-care services. For now, insurance companies have not changed coverage for mammograms for women in this younger age group. Our hope is that government policy makers working on health-care reform will recognize the need to continue annual mammography screening starting at age 40. But unfortunately, I believe the USPSTF’s latest recommendations will result in unnecessary deaths each year if women decide to forgo screening mammograms.