| v> | | | | 1,339; and the risk reduction is 14%. One possible |
| | | | interpretation is that it is acceptable to waste 1,338 |
| Please read here the guidelines for breast cancer | | | | screenings (1,339 — 1) but unacceptable to |
| screening and detection. This can save your life! | | | | waste 1,903 (1,904 - 1). If you are between 39 and |
| Breast cancer is the most common form of cancer in | | | | 49 years of age, is your life worth making 1,903 |
| women and the second leading cause of cancer | | | | other women have mammograms? Conversely, |
| deaths in American women. In 2009, approximately | | | | would you be willing to get a mammogram so that |
| 194,280 patients were estimated to be diagnosed | | | | one life out of 1,904 be saved? |
| with invasive breast cancer, and 62,280 with | | | | The harms of mammogram stem from |
| carcinoma in situ. An estimated 40,610 would have | | | | false-positives, meaning an abnormality on |
| died of this disease. For a woman of average risk, | | | | mammogram that turns out to not be cancer. The |
| the lifetime incidence of breast cancer is one in eight. | | | | USPSTF lists pain, anxiety, return doctor visit, and |
| | | | | unwarranted imaging and biopsy. Furthermore, |
| In November 2009, the U.S. Preventive Services | | | | overdiagnosis can happen, meaning that detecting |
| Task Force (USPSTF) published its recommendations: | | | | and treating that breast cancer would not make a |
| 1) against routine screening mammography in women | | | | difference in the woman’s lifespan. According |
| aged 40 to 49 years, and 2) for every other year | | | | to the USPSTF report, because the likelihood that |
| screening mammography for women between the | | | | DCIS (ductal carcinoma in situ, a form of early breast |
| ages of 50 and 74 years. The USPSTF states | | | | cancer) will progress to invasive cancer is unknown, |
| that the current evidence is insufficient to assess the | | | | surgical removal — with or without adjuvant |
| benefits of mammography in women 75 years or | | | | treatment — may represent overdiagnosis or |
| older. | | | | overtreatment. We know that in situ cancer can |
| These new recommendations sent shockwaves | | | | become invasive cancer that is potentially lethal; we |
| throughout the country. All major cancer | | | | just don’t know when and in whom. So if |
| organizations including the American Cancer Society | | | | it’s you, would you like to leave the DCIS in |
| voiced their disagreements with these new | | | | your breast and watch it grow? |
| government guidelines. It is a well known fact that | | | | Thanks to the outcry from doctors and patients |
| screening of asymptomatic women has been | | | | alike, the USPSTF statement is not being used to |
| accredited for the decline in mortality of breast | | | | deny insurance coverage for mammogram in women |
| cancer. This is particularly true for young | | | | aged 40 to 49 years. The current recommendation |
| women, the group less than 50 years old. Even the | | | | still stands, and it is annual screening mammogram |
| USPSTF agrees that among women between 39 and | | | | starting at age 40. The age at which screening is |
| 49 years of age, screening mammography results in | | | | stopped should be individualized by considering the |
| a 15% reduction in the risk of death from breast | | | | potential risks and benefits of screening in the |
| cancer. However, 1,904 such women need to have | | | | context of the woman’s overall health status |
| mammograms to prevent one single death. For | | | | and longevity. |
| women aged 50 to 59 years, the number needed is | | | | |