Annual Mammograms Under Fire…Again

Eileen Bailey Health Guide
  • Over the past several years, some experts have debated the need for annual mammograms, especially before the age of 50, unless specific personal or family medical history places someone at a high risk for developing breast cancer.  In 2009, the U.S. Preventative Services Task Force, a panel of medical experts, recommended biannual mammograms beginning at age 50. Even so, the American Cancer Society and the National Cancer Institute both recommend that, beginning at the age of 40, women receive annual mammograms.

     

    We reported on a study completed in 2012 which showed that annual mammograms resulted in overdiagnosis and unnecessary medical procedures because of false positives. We discussed a second study that found biannual mammograms were just as effective and beneficial, even for women over 50 years old.  Another study, completed in 2013 contradicted this information and stated that women, even those under 40 years of age, benefit from annual mammograms. The researchers for this study found that the majority of women who died of breast cancer had never had a mammogram.

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    New Studies Question the Benefits of Annual Mammograms


    Two recent studies, one published in February 2014 and one published in April 2014 both question the benefit of mammograms and the need for annual screening.

     

    A Canadian study, published in the British Medical Journal, questions the current screening guidelines and believes they should be reconsidered. The researchers tracked approximately 90,000 women over 25 years. They found that 22 percent of invasive breast cancers were overdiagnosed because the tumors were too small to cause symptoms or become life threatening. According to the study, having an annual mammogram did not lower your chance of dying from breast cancer.

     

    Another study, published in the Journal of American Medical Association, was completed at Harvard’s Medical School’s Department of Health Care Policy and Brigham and Women’s Hospital, found that the benefits of an annual mammogram don’t necessarily outweigh the risks. They found that while mammograms do lower the risk of dying of breast cancer, it is not by much. Instead, researchers believe that the current guidelines are too general and don’t necessarily reflect the needs of all women. Instead, they believe that guidelines should be based on the individual’s health profile, which should include family and personal medical history, genetic risk factors and overall life expectancy.

     

    No Consensus Between Experts

     

    The American Cancer Society, the National Cancer Institute and the American College of Obstetricians and Gynecologists stand by their recommendations that, beginning at age 40, women receive annual mammograms. They believe this is the best way to save lives.

     

    This year is five years since the U.S. Preventive Services Task Force issued their controversial decision to change their guidelines to have annual mammograms begin at age 50 rather than 40. They review their guidelines every five years, which means sometime this year, they will issue a statement as to whether they stand by their previous statement or they are again revising their recommendations.

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    No matter what the guidelines say, however, the best thing you can do is talk with your doctor about what is best for you. If you have personal or family history or other risk factors, your doctor may want you to start screenings even earlier than 40 years old. Or, your doctor may suggest waiting. Opening up a discussion about the pros and cons of annual screenings with your doctor is the best way to make the most informed decision about your health.

     

    References:

     

    “A Systematic Assessment of Benefits and Risks to Guide Breast cancer Screening Decisions,” 2014, April, Lydia E. Pace, Nancy L. Keating, The Journal of the American Medical Association

     

    “Twenty Five Year Follow-up for Breast Cancer Incidence and Mortality of the Canadian national Breast Screening Study: Randomised Screening Trial,” 2013, Anthony B. Miller et al, British Medical Journal

     

     

Published On: April 14, 2014