Mammograms for Women in Their 40s?

Breast cancer is one of the leading causes of death for females aged 40 to 49 in the United States. Mammography screening is seen as the first line of defense, but new evidence has physicians taking a second look at when it should be done and when it should not.

On April 2, 2007, the American College of Physicians released a set of new guidelines for the screening of breast cancer for women in their 40s. Rather than recommending mammograms for all women, they recommend physicians asses these women on an individual basis, and that the women be fully informed of both the risks and benefits of mammography. Why the change?

In an interview posted on website of the Wall Street Journal, Dr. Joann Elmore, a professor of medicine at the University of Washington, clarified the situation this way:

Breast cancer is one of the leading causes of death for females aged 40 to 49 in the United States. Mammography screening is seen as the first line of defense, but new evidence has physicians taking a second look at when it should be done and when it should not.

On April 2, 2007, the American College of Physicians released a set of new guidelines for the screening of breast cancer for women in their 40s. Rather than recommending mammograms for all women, they recommend physicians asses these women on an individual basis, and that the women be fully informed of both the risks and benefits of mammography. Why the change?

In an interview posted on website of the Wall Street Journal, Dr. Joann Elmore, a professor of medicine at the University of Washington, clarified the situation this way:

“As weve accumulated more data from clinical trials on breast cancer screening, we have realized that the absolute benefit in regards to mortality reduction for women in their 40s is less than we had hoped. Weve also learned that the risks [such as the cost and anxiety associated with false alarms] are higher.”

She goes on to say that although treatment for breast cancer has improved, and cure rates have gone up, the economics and politics of healthcare, the legal worries, and womens desire for greater involvement in their healthcare, have had an influence on clinical decisions for screening.

“A mammogram is a way to hope that if you are one of those unlucky individuals who get cancer, maybe your actions will help you. The evidence shows that it does help some women [in their 40s] but the evidence shows that its only six out of 10,000 over a decade, she continues.

The downside is the dreaded false positive test result. A diagnosis of breast cancer can cause a high level of fear, worry and stress; not only in the woman herself, but her spouse and family. There is also the cost, financial and psychological, of follow-up tests such as biopsies. So is universal screening worth it? The new guidelines speak for themselves.

A similar trial on breast cancer screening for women in their 40’s, done in the UK, was released last year and came to much the same conclusion, reports Dr. Buttery’s Public Health Blog.