Breast cancer is the second-leading cause of cancer death among women in the United States. Mammograms, as well as clinical breast cancer examination (CBE) and breast self examination (BSE), has long been touted as a major tool in detecting presymptomatic breast cancer. Now new revised government recommendation from the U.S. Preventive Services Task Force (USPSTF) for breast cancer screening is respenting a major shift in screening policy while, at the same time, creating a huge controversy and upsetting many patients and their doctors.“The recommendation to change breast screening is a huge step backwards,” says Dr. Marisa Weiss, Director of Breast Radiation Oncology, Director of Breast Health Outreach, Lankenau Hospital and a leading breast oncologist and founder and president of Breastcancer.org, the #1 source for breast cancer and breast health information and support.The proposed new guidelines recommend starting regular screening mammograms at age 50, rather than at age 40 as current guidelines recommend. They recommend screening before age 50 only for women with a much-higher-than-average risk of breast cancer. The proposed new guidelines also call for mammograms to be done every other year instead of every year, as recommended by current guidelines.The proposed new guidelines are based on research that looks at the effect of breast cancer screening on society from a public health perspective. This means the researchers were looking at how changing breast cancer screening guidelines would affect the overall public, rather than individual women. In proposing the changes, the task force members said that starting mammograms later in life and doing mammograms less often would save a large amount of money. It also means that about 3% more women would die from breast cancer each year. The task force members felt that the amount of money saved (from fewer mammograms and side effects of extra biopsies and treatment) was greater than the value of more lives saved (3% fewer women surviving breast cancer).”The data simply does not account for the human perspective. It would be an enormous mistake to allow outdated data using older technology provided by computer-generated analysis to dictate how health care professionals screen women for early detection of breast cancer. These are real people with their lives at stake … for whom mammography has a proven survival benefit.”Breastcancer.org noted that the analysis was based on older mammography techniques, meaning the researchers mostly looked at results from film mammograms instead of digital mammograms. The analysis did also not adequately consider the combined benefit of early detection (with current screening guidelines) and new treatments that have resulted in steadily improving survival rates in recent years.The proposed guideline changes would mean that many breast cancers would be diagnosed at a later stage, making it harder to become cancer-free. Later-stage diagnoses result in more women with metastatic disease (that has spread to other parts of the body) and more women with large or multiple cancers requiring mastectomy.Furthermore, the proposed guideline changes would mean that younger women would be diagnosed later. Breast cancer in younger women tends to be more aggressive, so early diagnosis and treatment is more critical for them. It is the lives and futures of younger women that would be lost if the proposed changes are adopted.Expressed as nameless, faceless numbers, the 3% decrease in breast cancer survival might seem like an acceptable trade-off when compared to the economic benefits of changing breast cancer screening policies. But breast cancer affects a very large number of women, so 3% of that number is not insignificant. The reality is that more women, mothers, daughters, sisters, grandmothers, and aunts, will die each year from breast cancer, which is neither reasonable nor acceptable.
