What are the New Guidelines on Mammograms
The American Cancer Society just recently changed their guidelines on breast cancer screening recommendations, which have tremendous influence on how often doctors order mammograms for women and may even have an effect on how often insurance companies will pay for them. These changes are causing a lot of controversy among doctors who specialize in the field as well as numerous researchers.
The changes announced by the American Cancer Society now are as follows:
- No longer recommend physical breast examination performed on women by their healthcare provider(s) entirely.
- Now recommend that women, without a family history of breast cancer, who are considered at average risk between the ages of 40 to 44, have mammograms at all.
- Now recommend women do not begin having mammograms until age 45, and then once a year until age 54.
- Reduced the frequency of mammograms in women age 55 and older from one mammogram every year to one mammogram every two years.
Why Some Experts Say Maybe You Should Ignore the New Guidelines
It is expected that there will be more than 40,000 deaths from breast cancer this year in the U.S. alone, as well as almost 280,000 new cases of invasive type breast cancer diagnosed. These statistics is why it is baffling to many professionals in the field who have devoted their entire careers to the early detection and the fight against breast cancer, that the American Cancer Society would reverse their early detection philosophy.
The society’s web page always stated (and oddly still does) that, “the American Cancer Society breast cancer screening guidelines are developed to save lives by finding breast cancer early, when treatment is more likely to be successful.” Their philosophy had been that mammography in all age groups; beginning at 40 years of age was the only means of testing that could accomplish that goal and reducing the risk of dying from breast cancer as much as 30 percent.
The dissenting experts in the field point out that the overall survival rate for breast cancer has reached an all time high of 90 percent, and primarily credit early detection through mammography for the success. While better treatment in breast cancer may play a part in the success rate of survival, without early detection these treatment options would not be as widely available.
Early detection means the tumor size is typically smaller and not as likely to have spread yet, thus treatment may be as simple as a lumpectomy, a much less radical approach to treatment and lessens the propensity for the need for chemotherapy and radiation treatments. The new guidelines for women over 55 years of age are even more troubling due to the fact that the new guidelines recommend mammography every other year, which means the possibility of larger tumors which may lower survival rates. Larger tumor sizes may reduce treatment options such as lumpectomy and mean more advanced and costly treatments, not only in the patient’s health outcome, but in actual dollars and cents.
The American Cancer Society’s reasons for changing the guidelines basically are that mammography is not a perfect method of detection and may give false positives. However, there should always be a secondary confirming diagnosis, with additional imaging techniques to eliminate the possibility of false positives. With the ensuing conflict between these two groups who were once allies in the fight of breast cancer it would seem it will now come down to the patient and their doctor to decide who is right and who is wrong. Women under 45 years of age will have to weigh their risks with their doctor on not having mammograms, as will those women who are older than 55 about how often they have one.
Let’s hope women will still be able to follow their own instincts and doctors guidance after these guideline changes and that the guidelines don’t allow insurance companies to make those decisions for us.