Nov 162009

This is a HUGE change in policy and as noted below is in line with international recommendations.  I have written numerous times questioning the advice to have a mammogram every year after age 40 for all of the reasons mentioned in this article and also because radiation even in small amounts always poses a risk, particularly since not only does it increase your risk of getting cancer but also because that risk is cumulative, so no matter how little you are  exposed to with one mammogram, it is added to your existing exposure load.  Please read this very important article in its entirety.

Excerpted from a  report by the AP:

Most women don’t need a mammogram in their 40s and should get one every two years starting at 50, a government task force said Monday. It’s a major reversal that conflicts with the American Cancer Society‘s long-standing position.

Also, the task force said breast self-exams do no good and women shouldn’t be taught to do them.

For most of the past two decades, the cancer society has been recommending annual mammograms beginning at 40.

But the government panel of doctors and scientists concluded that getting screened for breast cancer so early and so often leads to too many false alarms and unneeded biopsies without substantially improving women’s odds of survival.

The new guidelines are as follows:

  • Most women in their 40s should not routinely get mammograms.
  • Women 50 to 74 should get a mammogram every other year until they turn 75, after which the risks and benefits are unknown. (The task force’s previous guidelines had no upper limit and called for exams every year or two.)
  • The value of breast exams by doctors is unknown. And breast self-exams are of no value.

As I mentioned above,

International guidelines also call for screening to start at age 50; the World Health Organization recommends the test every two years, Britain says every three years.

This is a significant step to more rational breast care and hopefully a shift away from the profitable over-treatment of this disease at the expense of looking for the causes.

Addenda:  Breast Cancer Action has an excellent analysis of the changes and does a thoughtful and thorough job of addressing some very legitimate and understandable concerns:

Some people will be upset because their breast cancer was found on a mammogram that would not have happened under the new guidelines. Some people will be confused because they don’t understand what the downsides could possibly be to the early detection of breast cancer.

One thing to keep in mind is that mammograms are a medical intervention, and, like all medical interventions, they have benefits and risks. The benefits have to do with finding some cancers early enough to effectively treat them so that fewer women die of breast cancer. The risks are these:

  • False negative results (mammogram reads as clear, but there is breast cancer present)
  • False positive results (mammogram shows a problem, but biopsy reveals that the problem is not cancer). False positive results result in unnecessary biopsies, increased anxiety and stress, and physical scarring
  • Cumulative exposure to radiation. (Radiation is one of the few known causes of breast cancer. All radiation exposures accumulate in the body. Our bodies do not eliminate these exposures.
  • Diagnosis and treatment of cancers that are not life threatening at the time of diagnosis and will never become life threatening if untreated.

What is not well understood is that “early detection” doesn’t really mean what we’ve been lead to believe, which is that finding breast cancer early is the key to survival. It’s not that simple.

 November 16, 2009  Posted by on November 16, 2009

  One Response to “Government Issues Huge Change In Mammogram Recommendations”

  1. […] aware of for years now, despite the questionable evidence to support it.  For more on this, see here, here and […]

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