Screening
mammograms
save lives. There is no controversy there. But how often to screen and
at what age? This is where the varying opinions lie.
Two years ago, the American Cancer Society changed mammography recommendations,
ruling that for average-risk women, yearly mammograms should start at
age 45, not 40, and transition to every other year beginning at age 55.
This is in contrast to the longstanding recommendations of the National
Comprehensive Cancer Network and the American College of Radiology who
maintain that annual mammograms starting at age 40 are the standard of care.
A new study published in the journal “Cancer” sheds new light
on these disparate guidelines with hard numbers. The study by Dr. Elizabeth
Arleo and her colleagues found that yearly mammograms between the ages
of 40 and 84 would cut
breast cancer deaths by 40% , compared to a 31% mortality reduction with the new ACS
guidelines.
The study also looked at the most recent United States Preventive Services
Task Force guidelines, which recommend biennial screening between the
ages of 50 and 74. The USPSTF model found a mortality reduction of only 23%.
Despite inconsistencies in various screening guidelines, most organizations
agree in the importance of shared decision making and “individual
values.” Arleo’s study is just the latest evidence demonstrating
that women who value their lives above all, should have yearly screening
mammograms, starting at age 40.
The facts about
breast cancer are scary. One in eight women will develop breast cancer in her lifetime.
One in 69 will be diagnosed in her 40s. Over the last 10 years, Hoag Hospital
has diagnosed and/or treated 1,162 cancers in women between the ages of
40-49, and 464 of those cancers were in women between the ages of 40-44.
The scariest fact is that, despite advancements in treatment, breast cancer
remains the second leading cause of cancer death in women.
In addition to saving lives, early detection often results in breast conserving
surgery, better cosmetic results, lower treatment costs and potentially
avoiding chemotherapy and radiation. Without yearly mammograms, self-exams
and clinical breast examinations (which the ACS also recommends against),
early detection is virtually impossible.
Women should be encouraged to seek out improved screening and more effective
and tailored treatments. Breast Tomosynthesis, or 3D mammography, for
instance, has been found to increase the detection of invasive cancer
by up to 40%, while simultaneously reducing the rate of false positives.
Couple this with highly skilled, dedicated breast radiologists, and women
experience less anxiety and fewer biopsies.
Tens of thousands of women between the ages of 40 and 44 will develop breast
cancer this year. Without screening mammograms and breast exams, how or
when would these women be diagnosed? How many of them could die because
of a delayed diagnosis? It’s time to improve breast cancer screening,
not suppress it. The lives of countless mothers, sisters, wives and friends
depend upon it.
Dr. January Lopez is the director of Breast Imaging at Hoag Breast Center.
To view the original Daily Pilot article, please click
here.