Breast Cancer screening guidelines were revised last year by a group of health experts (US Preventive Services Task Force or USPSTF). Based on a systematic review of published evidence, they recommended women at average risk in the age group 50 to 74 have screening mammograms every two years instead of annually. For women in the age group 40 to 49, they left it up to the woman and her doctor to determine screening based on her risk factors and harm versus benefit preferences. This change sparked a firestorm fueled by proponents of annual mammograms and those concerned that insurance companies would require copayments. The emotionally charged opposition to the recommendations may have left many women confused. As we approach Breast Cancer Awareness month, it is important to revisit this topic and review any new findings.
It used to be that getting an annual mammogram for a woman over 40 was a simple way for her to be pro-active in monitoring her own breast health and to “catch” breast cancer in its early stages. However, doctors and scientists know now that this rite of passage is significantly more complicated than a yearly uncomfortable, and perhaps painful, xray. Some 45% of all women have naturally occurring dense breast tissue, and research has shown that this tissue can mask up to 50% of all breast cancers.
In the US, close to 80 million women each year meet the guidelines for mammographic screening to detect breast cancer. The idea is that if you detect cancer at earlier stages, your survival after treatment is significantly higher than if the cancer is found at later stages. While this is true, many women are unaware that if they have dense breast tissue (~40-50% of the women in the US), cancer can be missed 50% of the time.