This week the U.S. Preventive Services Task Force came out with a draft version of revised guidelines for mammography screening. The new recommendation endorses biennial screening mammography beginning at age 40 for all women. While this is an improvement over the prior recommendation to begin screening at age 50, it falls short of the current recommendation by the Society of Breast Imaging and the American College of Radiology to obtain annual mammograms beginning at age 40. Numerous studies have shown a significant increase in lives saved by early detection with annual screening mammography in women ages 40-74. Concern for radiation risk due to annual screening is really of no concern! The benefits of a mammogram each year far outweigh any risks from the minimal radiation dose. And concern for increased false positives and increased anxiety should also be reevaluated! Delaying a screening mammogram can delay detection of an early stage cancer, leaving a patient at risk of undergoing treatment for a larger, possibly more aggressive cancer. The small amount of anxiety associated with a mammogram should be compared with the larger amount of anxiety associated with a diagnosis of breast cancer. Lastly, the task force claims to need additional evidence to recommend additional screening in dense breast patients. The studies are out there… screening breast ultrasound has been shown to detect 4-6 additional cancers per 1000 women, and breast MRI detects up to 15 additional cancers per 1000 women. As we continue to make progress with the USPSTF, continued annual screening beginning at age 40 and advised supplemental screening in dense breast patients will remain the recommendation of both the SBI and ACR
Julie S. Gershon, M.D.