Recent Mammography Findings Under Fire
November 20, 2009
The Wall Street Journal
By Shirley S. Wang, Jonathan D. Rockoff and Barbara Martinez
The federally funded task force that loosened guidelines for breast-cancer screening this week clarified its position Thursday, in response to an intense backlash generated by its new recommendations.
Seeking to dispel confusion over some aspects of the new guidelines, task-force members said they never meant to convey that women in their 40s shouldn’t get mammograms, nor that they sought to discourage women from examining their breasts for signs of cancer.
Diana Petitti, a professor in biomedical informatics at Arizona State University who is vice-chairwoman of the panel — the U.S. Preventive Services Task Force — said she felt its conclusions were misinterpreted.
The task force is not against women having mammograms in their 40s,” Dr. Petitti said in an interview. Instead, she said, it is in favor of women in that age range deciding on their own, after consulting with their doctors, whether to undergo regular screenings.
Similarly, the task force merely intended to signal that primary-care physicians no longer need to teach women how to conduct self-examinations because of a lack of evidence that such outreach is effective. But it didn’t mean to deter women from the practice, which can sometimes lead to the early detection of cancerous lumps.
Dr. Petitti and other panel members expressed surprise at the uproar caused by their paper, published Monday in the Annals of Internal Medicine, while conceding they could have handled the message better. “We probably, in retrospect, could have been more clear,” Dr. Petitti said.
The new guidelines reversed a longstanding recommendation that women in their 40s automatically undergo an annual mammogram, an X-ray used to detect breast cancers, and stated that women aged 50 to 74 could reduce the frequency of such screenings to once every two years, from once a year.
Critics of the new guidelines have complained that the task force consists entirely of primary-care experts rather than oncologists, and that the panel’s decision may lead to a decline in coverage of mammography among health insurers for women in their 40s. Some critics say the new guidelines may lead to breast-cancer deaths among women in their 40s who forgo screening.
In reaching its conclusions, task-force members said they relied on large quantities of research published since 2002. They weighed the benefits of frequent screening against the harms of false positives, such as anxiety and unnecessary additional tests and biopsies.
Click here for the full report
