Seattle Cancer Care Alliance Radiology Director Responds To New Mammography Screening Recommendations

Main Category: Radiology / Nuclear Medicine
Also Included In: Breast Cancer;  MRI / PET / Ultrasound
Article Date: 17 Nov 2009 - 9:00 PST

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Following is a statement by Constance Lehman, M.D., PhD, medical director of radiology and director of breast imaging, Seattle Cancer Care Alliance; and professor and vice chair of radiology, University of Washington School of Medicine. The statement is in response to new breast cancer mammography screening guideline recommendations announced today by the U.S. Preventive Services Task Force. Among others, the task force said that screening mammography should not be done routinely for women age 40 to 49 years, that mammography should be performed every two years rather than every year for women ages 50-74 and that women should not be routinely screened after age 75.

"Women need a clear message: early detection offers a woman the best chance for a cure, and mammography is essential for early detection of breast cancer.

The Seattle Cancer Care Alliance continues to support annual screening mammograms for women beginning at age 40 as does the American Cancer Society. In fact, according to the ACS, 17 percent of breast cancer deaths in 2006 were among women who were diagnosed between ages 40 and 49.

"We know that digital mammography significantly improves the detection of cancer in young women and in women with dense breast tissue. These well-documented facts are not included in the analyses that led to the change in recommendations. It is important that women receive their mammograms at centers with the ability to provide high quality exams and that all women understand the importance of mammography for the early detection of breast cancer.

"Failing to identify those women in their 40s with cancer and having them wait until they are screened at age 50 is a disservice. By then breast cancer can be advanced and more difficult to treat."

Following are the American Cancer Society's breast cancer screening guidelines:

- Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.

- Clinical breast exam (CBE) should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for women 40 and over.

- Women should know how their breasts normally feel and report any breast change promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s.

- Women at high risk (greater than 20 percent lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15 percent to 20 percent lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15 percent.

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Source
Seattle Cancer Care Alliance