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Guidelines for Screening



 

To Our Patients:

As you probably know, the U.S. Preventive Services Task Force (USPSTF) recently withdrew its support for screening mammography for women 40-49 and for women over 75. They also recommended that women ages 50-74 be screened every two years instead of annually. In addition, they recommended against Clinical Breast Examination and Breast Self-Examination.

Those of us involved in the diagnosis and treatment of breast cancer in the Breast HealthCare Center at Missouri Baptist Medical Center disagree with these new guidelines. Under the current screening guidelines, it is well documented that breast cancer deaths have dropped 30% in women of all ages. Outlined below are significant problems we have with the USPSTF recommendations:

  1. The 16 member USPSTF had not one physician specializing in breast cancer screening, diagnosis or treatment on its panel.
  2. In our practice at the Breast HeathCare Center at Missouri Baptist Medical Center, we have diagnosed 456 breast cancers since 2007. Of those cases, 118 (26%) were in women under the age of 50!
  3. Screening mammography is the most carefully studied test in medical history, with 7 of 8 world-wide randomized screening trials showing a 30-44% overall decrease in breast cancer deaths in women screened with mammography. USPSTF disregarded these data, and claimed only a 15% reduction in breast cancer deaths in women 40-49. The actual decrease in this age group was 23-44%.
  4. The USPSTF claimed that false positive exams cause harm to patients by increasing pain and anxiety. In fact, the vast majority of screening mammograms actually relieve anxiety about breast cancer. For most women, it is a “good news” exam.

While there are no perfect tests in medicine, screening mammography is by far the best weapon we have in our war against breast cancer, and it is a proven one. We urge you to follow the recommendations of the American Cancer Society, American College of Radiology and the Society of Breast Imaging:

SCREENING MAMMOGRAM EVERY YEAR, BEGINNING AT AGE 40.

Please feel free to call one of us to discuss this issue in more depth.

Sincerely,
Geoffrey S. Hamill, MD, Section Chief of Mammography
MidWest Radiological Associates

Ms. Sarah Ernsky RN BSN, Breast HealthCare Center Manager
Missouri Baptist Medical Center

  

Download the recommendations from the American College of Radiology and the Society of Breast Imaging
Screening for breast cancer with mammography has been shown to decrease mortality from breast cancer, and mammography is the mainstay of screening for clinically occult disease. Mammography, however, has well-recognized limitations, and recently, other imaging including ultrasound and magnetic resonance imaging have been used as adjunctive screening tools, mainly for women who may be at increased risk for the development of breastcancer. The Society of Breast Imaging and the Breast Imaging Commission of the ACR are issuing these recommendations to provide guidance to patients and clinicians on the use of imaging to screen for breast cancer. Wherever possible, the recommendations are based on available evidence. Where evidence is lacking, the recommendations are based on consensus opinions of the fellows and executive committee of the Society of Breast Imaging and the members of the Breast Imaging Commission of the ACR.
J Am Coll Radiol 2010;7:18-27. Copyright ©2010 American College of Radiology
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