Will we ever get past the fallout and problems related to the U.S. Preventive Services Task Force’s (USPSTF) revised guidelines, issued a few years ago?
You know the ones; the ones suggesting that women 40-49 discuss the risks and benefits of having annual mammograms with their doctors and then deciding whether or not to have annual screenings.
Being told that annual mammograms might not be necessary until 50 is all some women in the 40-49 year range have to hear to give themselves permission to skip out on the anxiety and discomfort of annual mammograms.
Despite this report by USPSTF, the American Cancer Society and the American College of Radiology continue to advise women to begin annual mammograms at age 40.
In 2011, more than 290,000 cases of breast cancer are expected to occur in the U.S. of which, at least one-fourth of the diagnoses will occur in women under 50 years of age.
At a news briefing held in advance of the recently held Breast Cancer Symposium in San Francisco, Dr. Jamie Caughran presented the findings of a study that clearly shows that women who undergo regular mammograms present at earlier stages of breast cancer and often require less aggressive treatment. He states that this is true for women older than 50 years, as well as women aged 40 to 49 years for whom routine mammography is questioned by the USPSTF. Dr. Caughran is medical director of the Comprehensive Breast Center at the Lacks Cancer Center in Grand Rapids, Michigan.
Using a statewide breast cancer registry, the researchers examined data on 5,903 women diagnosed and treated for breast cancer between 2006 and 2009. Findings include but not limited to:
- Overall, 3,869 (65.5%) breast cancers were detected by mammography; 1,759 (29.8%) were detected by touch, and 4.7% by other methods. The vast majority (90%) of tumors found by touch were detected during self-exam; only 10% were found during doctor examination.
- In women under 50, about 48% of cancers were detected by mammography, while 46% were found by touch.
- Women with tumors found by touch had more advanced cancers; 50% and 17% were diagnosed at stage II and III, respectively, compared with 18% and 4% found through mammography.
- Forty-six percent of patients whose tumors were detected through touch underwent a mastectomy vs. 27% of those whose cancers were found by mammography.
- Twenty-three percent of women whose tumors were found by touch needed chemotherapy compared with 16% of women whose tumors were found by mammography.
Daniel B. Kopans, MD, professor of radiology at Harvard Medical School commented on the study, saying, “This paper reinforces what many of us have been saying ever since the USPSTF guidelines were issued. Mammography screening saves lives and women should be encouraged to participate from age 40.”
