Latest Breast cancer screening guidelines deemed unsafe by 80% women

By Dr. Ananya Mandal, MDMay 31 2011

Nearly 80 percent of women feel the new guidelines against breast cancer are unsafe as they stated that screening for those under 50 is not mandatory. The controversy over screening mammography flared up in late 2009, when a government-funded group of independent experts decided to change its recommendations. Instead of advising annual mammograms in all women age 40 and above, the U.S. Preventive Services Task Force (USPSTF) said women shouldn't routinely get screened until they hit 50, and those between 50 and 74 should only have mammograms every two years. But most of the women also seriously overestimate their risk of developing the disease, researchers from the University of Massachusetts Medical School in Worcester found.

To find out what women themselves thought, Autumn Davidson and her colleagues gave questionnaires to 247 women in their 40s who came to the hospital for an annual well-woman exam. More than eight out of 10 of the women said they wanted yearly mammograms, felt the new guidelines were unsafe, and wouldn't delay screening until they were 50. Most of them also had an inflated sense of their breast cancer risk. On average, they put U.S. Women's lifetime risk of developing the disease at 37 percent.

According to Davidson and other researchers, “Indeed, they have been exposed to consistent and high profile media campaigns, endorsed by medicine and a variety of interest groups, that have indoctrinated them into the concepts that mammograms lead to early detection and early detection saves lives.” The researchers did not advise against or for mammograms. . They simply decided to let individuals whether they should have them or not. They consider that the threat is not imminent as only 1 of 8 women will develop invasive cancer. However in the US the death toll in breast cancer is very high, second only to that of lung cancer.

According to Michael LeFevre of the USPSTF, about 30 out of 1,000 40-year-olds will die from breast cancer in the absence of screening. But if screening is started at 50 and done every two years until the women hit 75, seven of those deaths would be prevented. Starting at age 40 instead would stave off one more death. That extra risk reduction is real for individual women, but comes with a price tag. LeFevre said that mammography is painful for some women, and there will be a false alarm for one in two who are screened annually in their 40s. That is, the mammogram shows a suspicious mass that turns out not to be dangerous. In the meantime the woman has gone through additional testing, which exposes her to more radiation, and sometimes had a painful, invasive and expensive biopsy done. “Some women respond with increased stress and anxiety. The decision should be an individual one…To encourage women to have mammography there have been some fairly strong public relations campaigns.”

Elizabeth Thompson who is the president of advocacy group Susan G. Komen for the Cure stated that her main concern was that women under 40 would stop having mammograms based on the advice of researchers. Her group considers that women of average risk should have a mammogram once every year. “I don't think today that we have fear-mongering when one in three women will be diagnosed with (any form of) cancer in their lifetime, and one in two men,” she said.

The report appears in the American Journal of Obstetrics and Gynecology.