Posted on 10/20/2015 9:35:56 PM PDT by nickcarraway
You thought you were confused about mammograms before? Now the American Cancer Society has revised its guidelines, saying most women can start at age 45. The guidance still doesn't match what has been suggested by other groups and is sure to raise more controversy.
There's big disagreement over when and how often women should get mammograms. Until Tuesday, the American Cancer Society said women should get one every year starting at age 40, as well as regular breast exams by their doctors.
The new American Cancer Society guidelines are far more complicated. They say women of average risk of breast cancer can wait until they're 45 to have a first mammogram and should have them every year until age 55, and then start having them every other year.
"THIS IS ONE MORE SET OF RECOMMENDATIONS THAT WILL BE CONFUSING TO WOMEN AND THEIR PRIMARY CARE PROVIDERS." This is a little closer to the U.S. Preventive Services Task Force recommendations that most women can safely wait until they are 50 to start getting mammograms and that they need only one every other year.
The debate has become so heated at times that Congress passed legislation overriding the USPSTF guidelines, which are used as the basis for government health insurance policies.
Here are the American Cancer Society's new recommendations for women at average risk:
Women should undergo regular screening mammography starting at age 45.
Women 45 to 54 years of age should be screened annually.
Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually.
Women should have the opportunity to begin annual screening between the ages of 40 and 44 years.
Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer.
Clinical breast examination is not recommended for breast cancer screening among average-risk women at any age.
"The most important thing about our new guidelines is to validate that screening mammography is the most effective thing a woman can do to reduce her chances of dying of breast cancer," the cancer society's Dr. Richard Wender told NBC News.
"A woman should make a personal decision as whether she should start screening before age 45 but we clearly recommend that by age 45 all women should start regular screening every year."
For the new recommendations, published in the Journal of the American Medical Association, a team of experts studied all the research they could find on the risks and benefits of mammograms.
They found that regular mammograms in women aged 40 to 69 did reduce the number of breast cancer deaths.
This evidence outweighs the occasional study that finds otherwise — such as a large 2014 Canadian study that cast doubt on whether mammograms actually reduce the risk of dying from breast cancer, and a 2012 study published in the New England Journal of Medicine that found that as many as a third of cancers detected through routine mammograms may not be life-threatening.
The researchers said at the time that 1 million women may have been overdiagnosed, which means they were needlessly treated, not to mention emotionally distressed.
At least one study has showed that many women suffer intense anguish after they get called for a follow-up mammogram when a radiologist has spotted something suspicious.
One of the new studies used to revise the recommendations found that when women are diagnosed with breast cancer before menopause, the tumors often tend to be more dangerous and fast-growing. Women who are past menopause tend to have slower-growing tumors and thus it's safer to screen them every other year, the team at University of California Davis reported in the Journal of the American Medical Association.
Dr. Therese Bevers of MD Anderson Cancer Center, who helps set breast cancer screening guidelines for the National Comprehensive Cancer Network, doesn't think the new advice is going to clear up the confusion.
"This is one more set of recommendations that will be confusing to women and their primary care providers," Bevers said. "Women are going to have questions and their providers may not know how to address them."
Breast cancer is a leading killer of U.S. women. Every year, it's diagnosed in 200,000 women and a few men, and kills around 40,000.
Mammograms are an annual ritual for millions of American women, considered so important that federal law mandates that most health insurance plans pay for them without charging the patient anything. The X-rays can detect tiny tumors long before they are big enough to be felt.
"THE USPSTF'S DRAFT RECOMMENDATIONS AND THE NEW ACS GUIDELINES BOTH RECOGNIZE THAT A MAMMOGRAM IS A GOOD TEST, BUT NOT A PERFECT ONE."
And research clearly shows that treating a tumor early makes for easier, less invasive surgery and can save lives.
The guidelines are for women of average risk. Women whose mothers, sisters or other close relatives had breast cancer, or who know they have a genetic mutation that raises their own risk, should start sooner.
"Though the evidence shows that there are some benefits from mammography screening starting at age 40, those benefits more clearly outweigh the harms from age 45 onward," said Dr. Elizabeth Fontham, dean of the School of Public Health at Louisiana State University and the chair of the group that developed the guidelines.
"Still, some women will choose to begin screening between age 40 and 44, both because they are concerned about their risk of breast cancer, either in general or because they are at higher risk, and are less concerned about the chances of experiencing a false positive findings. Those women should have the opportunity to start screening at 40 if they choose."
The USPSTF issued a statement saying the new American Cancer Society guidelines are closer to its own.
"Importantly, both identify strategies that help women, together with their doctors, identify and treat this serious disease. We both found that the benefit of mammography increases with age, with women in their 50s, 60s, and early 70s benefiting most from regular mammography screening," the group said.
"The USPSTF's draft recommendations and the new ACS guidelines both recognize that a mammogram is a good test, but not a perfect one, and that there are health benefits to beginning mammography screening for women in their 40s."
The American College of Obstetricians and Gynecologists is sticking to its guidelines.
"ACOG maintains its current advice that women starting at age 40 continue mammography screening every one to two years and recommends a clinical breast exam," the group said.
What's most important, all groups agree, is for a woman to talk about her risk with her doctor, and decide what she's most comfortable doing.
Breast cancer risk can be genetic but most cases of breast cancer are in women who had no known family history of the disease.
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Just one of many policies I think we are going to have coming from the Washington bean counters.
No, there are too many tests being done with the risks outweighing the benefits. I know these developments coincide with the institution of the horrible Obamacare, but this is something wise doctors have been discussing for years. Doctors have forgotten the part about first do no harm.
Sorry, but we were sold a Bill of Goods. We were supposed to get MORE Preventative Medicine screenings with Obamacare, not FEWER. I can tell you that, when it comes to Pap Smears, the ‘no smears after age 65 unless you have symptoms’ is designed to make sure that women over 65 will surely die of their cancers instead of our Government having to pay to treat them. Cells frequently shed well before there are symptoms of genital cancers. But if you wait until you have symptoms, then the cancer is going to be further advanced when it is caught and, subsequently, much more difficult to treat. Please wake up and realize that your Government doesn’t really care about your health, they just want to control all those health care dollars.
She died at 50 years old. Diagnosed a year before, and it was already too late. The double mastectomy didn't do any good, and it just made her feel like there was less to live for.
She was, ahem, very well built. She had also become pretty heavy by that point in her life; prior to that she had a figure to stop freeway traffic.
She was brilliant, tall, witty, a modern dancer, a rock-n-roll drummer, a mother, a wife, and had a sharp sarcastic sense of humor. She also had decades of life left to live. She was from Texas and proud of it.
She didn't like mammograms, and put the process off, over and over.
I miss ya, B. You were a good, loving friend and a helluva lady. 50 is way too young to die.
“At least one study has showed that many women suffer intense anguish after they get called for a follow-up mammogram when a radiologist has spotted something suspicious.”
And how does that compare to the anguish of being told “too bad we didn’t find this a 18 months ago before it metastasized, but we didn’t look because you were only 43”?
“No, there are too many tests being done with the risks outweighing the benefits.”
Mamograms are basically risk free. This is more of the collective being more important than the individual. Because the hard cold fact is that many women will die from this because their cancer will not be found in time. The risk is that a few will get false alarms that take a few days to clear up. A VERY small price to pay against your very life.
This new guideline does not make any sense to me. MANY women have had this cancer in their late 30’s or early 40’s and now it won’t be caught in time. I shouldn’t talk as I’m at the age to get one but I don’t want to cause I heard it’s painful and I’m very sensitive on top of it. There’s no breast cancer in my family anyways.
They can do mammograms , read them give results and do follow up all in one visit. Lazy. Don’t care. Cost containment.
But if she wanted a sex change operation, her policy covers it. I'm not kidding.
Obamacare has made a mess of health insurance and health care that will only get worse. And more people will die as a result.
Mammography is extremely painful and can help spread cancer with the intense pressure. Believe me, if men were tested by squeezing their cojones in a vice, insurance would cover a less invasive test within months.
I agree with you that mammograms are outdated. I don’t understand with all the money raised for breast cancer, why they haven’t done more work on that. I remember reading they were outdated in 1999. By now, thermograms, or something else, should be standard.
My doc told me back a few years ago this would happen. He mentioned Obamacare would force these later diagnostics to save overall costs. Same happened for colon cancer screenings.
My wife works in this field and she’s been saying this for 15 years that mamos don’t help as much as people think. It was always a political issue more than a healthcare issue. It has been known for a long time that the long term scientific objectives (extending life) have always been outweighed by the optics of pink ribbons and politicians leading political rallies masked as “cancer walks” promising to spend more of other people’s money.
>The researchers said at the time that 1 million women may
>have been overdiagnosed, which means they were needlessly
>treated, not to mention emotionally distressed.
“Overdiagnosed” = given effective screening for breast cancer
They are doing the same with prostate cancer. They want to do away with PSA testing. They do not want us to live too long, especially when we have outlived our economic use usefulness.
Death panels at work.
Yes, she’s right. There have been huge studies that don’t make the mainstream (in the USA) because they contradict Big Cancer. Manmograms do not save lives, period. They find all kinds of harmless cancers and precancers and then the poor women is browbeaten into treatment she never needed, and finally the treatment destroys her immune system and she dies earlier than she would have if she did nothing, and not always from cancer. 10% of the people dx’ed with cancer from mammograms are helped or had their lives lengthened. That just isn’t good enough to push on everyone.
Plus the test is unnecessarily invasive and painful.
One of the most telling studies about the power of the cancer machine is one that tracked a woman’s decision whether to treat based on a doctor telling her that the mammogram picked up carcinoma in duct situ either saying that is spotted some abnormal cells, or saying that it was cancer. The poor women decided much more often for drastic treatment and surgery when the C word was used, when “abnormal cells” that might never cause any problems would be very true.
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