Are Fewer Mammograms Better?
The United States Preventive Services Task Force (USPSTF) earlier this November issued new guidelines regarding mammograms and breast self-examination which have resulted in recent controversy. These recommendations can be found at the website of the Agency for Healthcare Research and Quality (AHRQ).The recommendations are that the minimum age for regular mammograms administered to healthy women with no family history of breast cancer be raised to age 50 and that such women do not need to perform regular breast self-examinations until they reach age 50. Given the size and influence of the breast cancer lobby and the number of ordinary, concerned women who aren't lobbyists, this has caused an uproar of protest. Objections have been raised by patients, and not all medical professionals agree with the USPSTF. Both the American Cancer Society and the American College of Obstetricians and Gynecologists continue to recommend starting annual mammograms at age 40.
The reason given for raising the minimum well-woman mammogram age is that the harm for women under age 50 outweighs the benefits, according to the USPSTF report. The incidence of false-positive mammograms in women under age 50 is significantly greater than that for women 50 and older. False positives result in anxiety for the patient and wasted expense in terms of unnecessary biopsies and other tests and procedures which must be performed to rule out cancer. According to Barbara Brody, health editor of Woman's Day, breast tissue in women who have not yet reached menopause is dense, which makes tumors more difficult to detect and gives rise to false-positive mammogram results.
Another possible danger is that mammograms performed too frequently can actually cause the very disease they are designed to detect. A mammogram is an x-ray of the breast, and excess amounts of x-radiation can cause cancer in people with a predisposition to it if they are exposed many times over a decade.
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