Long an advocate for early, frequent breast cancer screenings, the American Cancer Society has done an about-face and is now recommending that women begin getting mammograms later and do so less frequently than before, according to new guidelines published this week.
According to the New York Times and the San Jose Mercury News, the group is now suggesting that women start annual screenings with mammograms at age 45 instead of age 40, as previously suggested. In addition, the organization is advising women to shift from annual checks to biennial screenings (once every two years) beginning at age 55.
The American Cancer Society also said that it no longer recommended clinical breast exams, in which doctors or nurses feel for lumps, in women of any age who have experienced no previous symptoms or abnormalities in their breasts. The guidelines are based on increasing scientific evidence that mammograms are less useful in younger females, and that the screening process can result in false-positives requiring unneeded biopsies and testing.
“It’s a step in the right direction,” University of California, San Francisco professor of medicine Dr. Karla Kerlikowske, who also directs the Women Veterans Comprehensive Health Center at the San Francisco Veterans Affairs Medical Center, told the Mercury News. “They consider that there are harms to screening healthy people who aren’t going to get the disease.”
Confusion, controversy likely to continue
However, Dr. Therese B. Bevers, the medical director of the Cancer Prevention Center at the University of Texas M.D. Anderson Cancer Center in Houston, told the Times that she believed the new guidelines had “the potential to create a lot of confusion amongst women and primary care providers.”
One of the reasons for such confusion is differing recommendations issued by different groups. The American College of Radiology recommends that women begin getting mammograms at the age of 40, but the US Preventive Services Task Force suggests holding off until age 50, and even then only getting a mammogram every other year through the age of 74.
The National Comprehensive Cancer Network, a coalition of leading American cancer centers, recommends mammograms every year starting at age 40, the Times indicated. The American College of Obstetricians and Gynecologists recommends them every year or two from ages 40 to 49 and every year after that, as well as annual clinical breast exams starting at age 19.
Officials from the Cancer Society and other groups have scheduled a meeting for January in the hopes that they will be able to develop a more consistent set of guidelines, reports indicate. In all instances, however, the Cancer Society emphasizes that none of its recommendations are written in stone, and that all such decisions should be made by women and their doctors.
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