Hear from MUSC’s Dr. Megan Baker Ruppel:
The Comprehensive Breast Care team at Hollings Cancer Center at the Medical University of South Carolina, strongly opposes the screening mammography recommendations released by the United States Preventative Services Task Force (USPSTF). We believe that the data presented are not compelling enough to abandon evidence-based, validated screening mammography guidelines.
In the USPSTF analysis, screening mammography has been shown to reduce mortality in every age group, including women age 40-49 and women over 74 years old. Admittedly, this comes at the cost of false positive results and additional procedures.
In the group most at risk for this issue, those 40-49 years old, five women will undergo an additional biopsy procedure for every breast cancer detected. This screening schedule, however, will reduce breast cancer deaths in that age group by 15 percent.
To be most efficient with resources, the USPSTF deems it acceptable to lower the sensitivity of a national screening mammography program from the current detection rates of 90% of all breast cancer to 70 percent in the future. In an era of limited resources, when early detection and prevention are paramount and critical for cost savings, this recommendation is ill advised.
Furthermore, the task force recommends that women undergo yearly risk assessments to evaluate their need for a mammogram. Unfortunately, this risk assessment is rarely performed; and a significant gap in health care education from providers remains.
Additionally, the task force did not account for the shift in disease progression that will occur. With earlier detection, we have made tremendous strides in preserving women’s breasts, decreasing the need for mastectomy (removal of the breast) by over 40% in the past twenty years. If we allow breast cancers to grow undetected, this will result in more mastectomies and increasing use of chemotherapy.
Unlike other health care systems that were included in this analysis, the U.S. healthcare system is not structured to ensure that women will be encouraged or compliant with these recommendations. Much of the success of our current screening recommendations lies in their elegant simplicity.
We at Hollings Cancer Center are joined by our colleagues in the American Cancer Society, the National Comprehensive Cancer Network, the American College of Radiology, the American Society of Breast Disease, the American Society of Breast Surgeons, and the Susan G. Komen Foundation, and the American College of Obstetricians and Gynecologists in our opposition to these current recommendations and our continued advocacy on behalf of our female patients.
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This post was mentioned on Twitter by kathleen_ellis: MUSChealth
RT @MUSCHealth What do u think about new mammogram guidelines? Tell us your thoughts. http://tinyurl.com/yjr3xqx…
Dr. Baker’s interview on Channel 2 was superb. Excellent.
[...] Blog where “MUSC Responds to New Mammography Recommendations”, which was also promoted/distributed with [...]
Why don’t you publish SOMEWHERE online, the phone number for making an appointment? I go through this annually and just end up at the switchboard. Some women might just give up, which would be tragic
I am 63 years old and I have had annual mammograms for many years.This August a lump was detected that resulted in a diagnosis of invasive intraductal carcinoma in my left breast. A 1.6 cm malignant tumor was discovered and I opted for bilateral mastectomy as I am at high risk for breast cancer and didn’t want to take the chance of having to have another mastectomy due to this cancer at a later date. The radiologist who read the mammogram this year said that he was able to detect the lump in the mammogram from last year, which was read by a different radiologist who missed it. Had I waited for another year per the controversial recommendations, it would have been too late and I would have had an even less favorable prognosis. I was thankful that there was no lymph node involvement and that the surgery “got it all”, even though I am now facing chemotherapy which could have possibly been avoided had the tumor been discovered a year ago. If mammograms were a more reliable diagnostic tool, then perhaps it would be plausible to be screened every other year. Also, it is astounding to me that with as many as 190,000 women per year being diagnosed with breast cancer, “they” haven’t been able to come up with more accurate diagnostic methods and safer treatments.
Hi, I applaud your blog for informing people, very interesting article, keep up it coming