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American Cancer Society Got It Wrong

Published on | Eric Brown

brst-mam-cad14Recently, the American Cancer Society updated their recommendations regarding screening mammography.

To summarize I believe that the ACS methodology for their guidelines analysis was excellent. They reviewed both current and old scientific articles, they sought out the opinions of experts in breast cancer diagnosis and treatment, and they utilized scientific data in their guideline development.

However, as has become quite common, they erred in their interpretation of the data. In the article it is clearly stated that screening annually saves the most lives. Why then the qualifiers for women 40-44 and women over 55 years – recommending screening every other year. The rationale behind these qualifiers was due their thought that the “harms””of screening outweighed the benefits and that the incidence of cancer in the 40-44 group is not “high”enough to recommend it.  This is inappropriate.

1 out of 2,212 breast cancer diagnoses will be a 30-year-old woman.

The “harm” of a mammogram is a ‘false positive’.  A false positive mammogram is one whereby a women is asked to return for additional mammogram views or an ultrasound.

  • ONLY 2% LEAD TO BIOPSY
  • INCREASES ANXIETY FOR SURE
  • PUBLISHED DATA: THOSE WHO ARE RECALLED (THOSE WITH A FALSE POSITIVE MAMMOGRAM) STILL ENDORSE YEARLY SCREENING

Women and health care providers should be provided with accurate scientific information and then each woman can made an informed decision about whether to be screened, when to start and how frequently to do it.

Keeping mind that screening of any kind allows for the early detection.

  • EARLY BREAST CANCER DETECTION:
    • REDUCES DEATH
    • EXTENDS LIFE EXPECTANCY
    • IMPROVES QUALITY OF LIFE
    • ENABLES LESS EXTENSIVE SURGERY
    • FEWER MASTECTOMIES
    • LESS FREQUENT OR AGGRESSIVE CHEMO

I am hoping that the clinicians involved with breast care will support the recommendation of yearly screening mammogram to begin, in average risk women, at age 40 years.  Mammography should continue until one’s natural life expectancy is less than 10 years.  Many patients and health care providers are confused about the different guidelines from different groups.  Unfortunately, recommending less than the historic standard provides for intrigue and thus marketable material for the media outlets lending credence to a change that ultimately will cost lives.


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