BHealthy Blog

Mammogram. Should you or shouldn’t you?

By now you have probably heard about the controversial recommendations provided by the U.S. Preventive Services Task Force regarding screening mammograms.

If—like me—you had never heard of the U.S. Preventive Services Task Force before this came out, here’s what I learned in a statement from the American College of Radiology and the Society of Breast Imaging:

The USPSTF is an independent panel of primary care physicians funded and staffed by the HHS Agency for Healthcare Research and Quality (AHRQ). The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) gave HHS the authority to consider USPSTF recommendations in Medicare coverage determinations for additional preventive services. Recently, Congress has expressed their desire to broaden this authority and enhance the role of the USPSTF in terms of its impact on coverage for existing services. Additionally, private insurers may incorporate the AHRQ-funded USPSTF recommendations as a cost-savings measure.

These two groups feel very strongly about the task force’s guidelines saying, “If cost-cutting U.S. Preventive Services Task Force (USPSTF) mammography recommendations are adopted as policy, two decades of decline in breast cancer mortality could be reversed and countless American women may die needlessly from breast cancer each year.” And further: “Ignoring direct scientific evidence from large clinical trials, the USPSTF based their recommendations to reduce breast cancer screening on conflicting computer models and the unsupported and discredited idea that the parameters of mammography screening change abruptly at age 50. In truth, there are no data to support this premise.”

A recent letter that was sent to every woman that has had a mammogram at our breast center defines Baptist Health’s stance:

To Our Patients:

Every woman needs a screening mammogram every year beginning at age 40.

The U.S. Preventive Services Task Force (USPSTF) recently withdrew its support for screening mammography for women ages 40 to 49 and for women over 75, and it recommended that women ages 50 to 74 be screened every two years instead of annually. Those of us involved in the diagnosis of breast cancer here in Arkansas disagree with these new guidelines.

Under the current screening guidelines, we have seen a 30 percent drop in breast cancer deaths in women of all ages. The USPSTF recommendations have some real problems:

  • The 16-member task force did not have one physician specializing in breast cancer screening, diagnosis, or treatment on its panel.
  • In our practice at Radiology Consultants of Little Rock, we have diagnosed 892 breast cancers since 2007. Twenty percent (175) were in women under age 50. These may have gone undiagnosed in the early stages had the USPSTF guidelines been in force.
  • Screening mammography is the most carefully studied test in medical history with multiple comparison studies worldwide showing a 30 to 63 percent decrease in breast cancer deaths in women undergoing screening mammography.
  • The USPSTF claimed that false positive exams cause “harm” to patients by increasing pain and anxiety. In reality, screening mammograms actually relieve anxiety about breast cancer.
  • We urge you to follow the recommendations of the American Cancer Society:

Yours very truly,

Amanda J. Ferrell, M.D., Medical Director
Baptist Health Breast Center
Radiology Consultants

Seems to me there’s some pretty clear evidence that we should continue to start screening once we hit 40. And as for “pain and anxiety,” it’s not that painful to most women and I’d really rather know as early as possible whether or not I have breast cancer.

What do you think? Do you feel comfortable waiting until the USPSTF’s recommended age to begin screening?