Yesterday, The United States Preventive Services Task Force (USPSTF) announced that it was changing its guidelines for mammography and no longer recommending routine screening for women between the ages of 40 and 49. As a breast surgeon, I strongly disagree to the recommendations released. I believe there is adequate data to support annual digital mammography screening for women ages 40 and older.
Most recent data shows that 17% of breast cancer deaths happened in women who were diagnosed in their 40s, and 22% occurred in women diagnosed in their 50’s. In terms of cost-effectiveness, practical use, and precision, digital mammography is the best screening tool for the early detection of breast cancer. To limit its use will mean that breast cancers will go undiagnosed for a longer period of time. Early detection often allows for breast conserving surgery and possible avoidance of chemotherapyTreatment with drugs to destroy or slow down the growth of cancer cells. Often referred to as systematic treatment, because it acts throughout the body, as opposed to localized treatments, like surgery or radiation.. The limitation of an annual digital mammography screening potentially crushes these options for women 40-49.
Like the American Cancer Society I will continue to recommend annual screening using digital mammography to all women beginning at age 40 and clinical and breast self examinations for women beginning at the age of 18. There is no known cure for breast cancer, though the earlier it is caught increases a woman’s chance of survival. A breast self-exam is not a diagnostic practice but a tool that encourages a woman to recognize any changes that may occur in her breast; a clinical examination allows an expert to confirm any suspicious changes and a digital mammography enhances visibility by up to 300% making it more likely to see lumps and other abnormal changes that may be present in the breast tissue. Women need to fight this disease from a position of strength and knowledge and advocate for their own health with these three components of early detection. Breast cancer is a major health problem to too many women; a digital mammography screening reduces breast cancer mortality and saves lives.