Mammogram Recommendations Disputed By Scientific Studies

Women under 50 who follow the advice of a U.S. panel to forgo annual mammograms may be at risk for more severe forms of breast cancer
Three recent studies led by radiologists suggest that failing to get regular breast screenings left women more likely to discover cancer at an advanced stage. The delay resulted in larger tumors and a worse prognosis once the cancer was uncovered, the data found.
The U.S. Preventative Services Task Force said in 2009 that most women ages 40 to 49 do not need mammograms, recommending the screening for those with a disease history or who had a greater risk due to another factor.
The American Cancer Society disputed the advice, and insurers still cover annual screenings.
However, a study in Colorado suggests 62 percent of doctors changed their advice to match the U.S. guideline and 16 percent fewer women got the test.
The three studies were presented at separate medical meetings held recently by the American Society of Breast Surgeons in Washington D.C., and the American Roentgen Ray Society in Chicago.
Breast cancer killed an estimated 40,000 women last year and is the second leading cause of death among women, exceeded only by lung cancer. The American Cancer Society estimated that about 207,090 new cases of invasive breast cancer were diagnosed in 2010.
In issuing its recommendations, the federal task force said women in their 40s are more likely to get false-positive tests that lead to unnecessary biopsies and anxiety than to discover cancer through a mammogram.
The guideline was challenged by the cancer society, which urged doctors to advise women of that age to continue routine annual screenings.
The independent task force under the U.S. Agency for Healthcare Research and Quality, was first formed in the 1980s to give advice on screening, counseling and preventive medicines based on an assessment of scientific
Academic and practicing doctors and nurses make up the group. They have published guidelines on more than 100 topics and are reviewing 30 more, involving cervical cancer tests, dementia and glaucoma screening and the use of electrocardiographs for detection of coronary heart disease.
One of the studies analyzed breast cancer cases in women younger than 50 from 1998 to 2008. The study showed that 94 percent of the women ages 40 to 49 diagnosed through a mammogram were considered disease free after five years compared with 78 percent of those who didn’t receive the screening exams.
Another study studied biopsy results from Jan. 1, 2008, to Dec. 31, 2009. Seventy-one of 108 diagnosed breast cancer cases were detected by a mammogram and 37 resulted from discovery of a lump or other symptom. Twenty-two cases were non-invasive cancer in the tested group compared with one among those who were not.
None of the cancers in the mammogram group had progressed to latest stage form of the disease compared with 17 among those who weren’t screened.
More than half of the women who had a mammogram showed no evidence of cancer in their lymph nodes compared with 39 percent in the group that hadn’t been screened, The study also showed the size of the tumors to be on average smaller among the women whose cancer was discovered in a mammogram.

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