Mammograms risky, doctors say…

In This Month’s Issue:

1 April – Mammograms risky, doctors say…

Dateline Washington 4-3-07, from the American College of Physicians.

The ACP (representing 120,000 internists) are challenging the widely accepted recommendation that women should routinely have mammograms in their 40s, saying the risks of the exams may outweigh the benefits.

They suggest that women consult with their doctors individually about whether to get the x-rays. The advice is based on a comprehensive review of research on mammography that concluded the benefit is less clear for women in their 40s than for those 50 or older, and that the screening carries significant risks (exposure to radiation, unnecessary biopsies, surgery and chemotherapy).

These guidelines conflict with longstanding recommendations from the American Cancer Society and National Cancer Institute.

The new guidelines elicited mixed reactions from breast cancer advocates, doctors and researchers. Some condemned the review, saying mammograms clearly help catch tumors early (most treatable stage), adding that breast cancer tends to be especially deadly when it strikes women in the 40s age group. Since the 1990s, the Cancer Society (and other groups) has recommended mammograms every year or two for women beginning at age 40, and they credit the exams with reducing death rates.

Spokesman for the U.S. Preventive Services Task Force which issues the federal government’s official recommendation on preventive medicine says: “I would like to see more women stop and think about the decision.”

The new guidelines come less than a week after the Cancer Society issued new guidelines that, for the first time, recommend that women at greatest risk for breast cancer also undergo annual MRI exams. That statement triggered a similar debate over the risks and benefits of aggressive screening.

The conflicting recommendations may confuse women, but the panel concluded it was important to present women with realistic assessment. “All we are saying is that women should be informed about the risks and benefits so they can make a decision based on all the facts.”

Breast cancer strikes more than 212,000 women each year in this country and kills more than 40,000, making it the most common cancer found in women after skin cancer, and lung cancer.

So, the controversy continues with some researchers saying the benefit in that age group is marginal and subjects thousands to overdiagnosis and overtreatment as well as the radiation exposure issues.

One thing nobody added to the discussion is that the procedure is quite painful, just ask a woman who has had one. Best advice: Do your homework before you make a decision.