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We, as physicians and experts in breast cancer, agree with the longstanding recommendations of the American Cancer Society for screening mammography, beginning with annual exams at age 40. We disagree with the United States Preventive Services Task Force (USPSTF) recent change in guidelines. We fear that this will discourage women from having mammograms and result in unnecessary deaths from breast cancer.
We believe their flawed analysis of old data underestimates the number of lives saved by mammography. Furthermore, modern digital technology has improved cancer detection in this age group. Even if one accepts a mortality reduction of 15 percent put forth by the USPSTF (rather than 30-40 percent as has been shown in multiple randomized controlled trials), we feel those lives are worth saving.
They estimate 1,904 women in their 40s must be screened to save one life, which they find unacceptable. For women in their 50s 1,339 women must be screened, and they deem this acceptable. We agree with the American Cancer Society that “the lifesaving benefits of screening outweigh any potential harms.” At least 40 percent of years of life saved by mammographic screening are of women aged 40-49.
We feel that all lives saved are important, at any age.
Katherine E. Dee, MD, Seattle Breast Center