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No Mammogram at 40? What Are You Risking?

admin - May 9, 2011



Friday we posted that many women in their 40s are still insisting on mammograms. What about those who don’t?

A recent article in Bloomberg reports that, according to recent studies, breast cancer survival rates would be affected if women under 50 followed the November 2009 recommendation from the U.S. Preventive Services Task Force (USPSTF).

If you will remember, the USPSTF had stated in 2009 that most women do not need mammograms before 50, which, as you can imagine, started a huge controversy with many people in the health community, including The American Cancer Society, weighing in against such advice.

In an effort to present actual evidence against such a suggestion, according to the Bloomberg article, three studies by radiologists were presented in two meetings: One by the American Society of Breast Surgeons in Washington and the other by the radiologist association, the American Roentgen Ray Society, in Chicago. Following are the teams, study information, and the findings:

STUDY 1: Paul Dale, a study researcher and chief of surgical oncology at the Ellis Fischel Cancer Center at the University of Missouri School of Medicine, Columbia, and colleagues analyzed breast cancer cases in women younger than 50 from 1998 to 2008.

  • 94% of women diagnosed ages 40 to 49 diagnosed through a mammogram were considered disease free after 5 years compared to 78% of those who didn’t receive mammograms

STUDY 2: Donna Plecha, a radiologist at University Hospitals Case Medical Center in Cleveland, whose team analyzed biopsy results from Jan. 1, 2008, to Dec. 31, 2009.

  • 71 of the 108 diagnosed breast cancer cases were detected through mammograms and 37 were detected by self discovery
  • 22 of the 108 diagnosed breast cancer cases were non-invasive cancer in the mammogram group compared to 1 in the group not screened
  • None of the mammogram cases advanced to late stage cancer compared to 17 among those not screened
  • More than half the mammogram cases had no cancer spreading to lymph nodes compared to 39% of those not screened

STUDY 3: Lara Hardesty, a radiologist at the University of Colorado in Aurora, let a team that compared the number of women who had mammograms nine months before and after the task force’s new guidelines.

  • A 16% reduction in the number of mammograms following the task force’s recommendations was reported

Hardesty’s team also conducted an e-mail survey of primary care physicians and gynecologists at her institution to see if they changed how they recommend mammograms to their patients since the Preventive Services Task Force advice. While the article did not provide details, it did cite her thoughts regarding early treatment:

The earlier we find cancer the more treatable it is and it’s my concern that, for some of them, we will be missing an opportunity for early diagnosis,” she said. “I realize I am a radiologist and this is my livelihood, but I am also the one who has to tell a young woman she has breast cancer.”




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