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Panel sticks with mammogram advice

Karen Kaplan Los Angeles Times

An expert panel convened by the federal government is standing by its controversial recommendation that most women should get mammograms to check for signs of breast cancer only once every two years, and that the tests need not begin until the age of 50.

The draft report from the U.S. Preventive Services Task Force reiterates that mammograms do indeed save lives. But it also emphasizes the test’s downsides, many of which are unappreciated by doctors and the general public.

Chief among the problems associated with screening mammography is the risk that it will result in unnecessary procedures and treatment by finding abnormal cells that would have been harmless if left alone, according to the panel, which first raised questions about the test in 2009.

“About one out of every five women diagnosed by screening mammography and treated for breast cancer is being treated for cancer that would never have been discovered or caused her health problems in the absence of screening,” according to the report released Monday.

Breast cancer is the second-leading cause of cancer death among women in the U.S., after lung cancer. Among every 10,000 women in the U.S., about 125 are diagnosed with breast cancer each year and 22 die of the disease. That translated to about 233,000 new diagnoses and 40,000 deaths in 2013.

Several groups – including the American Cancer Society, the National Comprehensive Cancer Network and the American College of Radiology – continue to recommend annual mammograms for women at average risk of breast cancer beginning at age 40.

But the task force reiterated its advice that most women get tested only once every two years, and that the test is most effective for women between ages 50 and 74.

Overall, the panel determined “the net benefit of screening mammography in women ages 50 to 74 is moderate.”

But for most women in their 40s, the net benefit of screening is too small to warrant a blanket recommendation in its favor, the panel determined.

However, if women in this age group have a mother or sister who has been diagnosed with breast cancer, their own risk of the disease is comparable to that of a typical woman in her 50s. Biannual screening for these women makes sense, the panel wrote.

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