Newspaper article The Tuscaloosa News

New Breast Cancer Screening Guidelines: Clarity or Confusion?

Newspaper article The Tuscaloosa News

New Breast Cancer Screening Guidelines: Clarity or Confusion?

Article excerpt

SEATTLE | The American Cancer Society aimed for clarity with revised breast-screening guidelines released Tuesday, but some doctors and patient advocates worry that most women will still be confused about their care.

Women at average risk of breast cancer should start getting mammograms at age 45, and get them annually until age 55, when they should be screened every other year, the new guidelines say. Plus, women can skip routine breast checks.

Thats a change from the societys 2003 advice, which recommended mammograms every year starting at age 40, plus regular manual exams by doctors.

And its closer to, but still different from, the U.S. Preventive Services Task Force, or USPSTF, recommendations that say most women can wait until age 50 to start getting mammograms and then get them every other year.

The result? Many women still wont know what to do, said Dr. Joann Elmore, a University of Washington professor of medicine and epidemiology who studies breast screening.

I think the practical effect might be confusion, Elmore said. Women may be frustrated by the variability of these back-and-forth guidelines.

Questions about when and how often women should get mammograms have been a hot debate for years, including the USPSTF guidelines used as a basis for government health-insurance programs.

The new guidance likely wont help, said Teri Pollastro, 55, a patient advocate with Seattles Fred Hutchinson Cancer Research Center who has been living with Stage 4 metastatic breast cancer for years.

I think its going to be more confusing, personally, Pollastro said. My hope for these guidelines is that they will spur a conversation between their primary-care doctor and the patient about what is the right age for me: Is it 40 or 45?

Prompting such conversations is the point of the new guidelines, which were based on a rigorous, systematic review of evidence published Tuesday in JAMA, the Journal of the American Medical Association.

A panel of researchers spent more than two years reviewing all available data about breast-cancer screening, said Ruth Etzioni, a Fred Hutchinson biostatistician who helped draft the recommendations.

The study showed that regular screening exams in women age 40 to 69 reduced the number of breast-cancer deaths. The recommendations aimed to balance the known benefits of mammogram screening with potential risks and harms, including problems with over-diagnosis and overtreatment, Etzioni said.

Theyre saying you dont all have to run for mammograms at age 40, Etzioni said. Its giving women more flexibility. In a way, its saying, Dont panic.

About 230,000 women in the United States are diagnosed with breast cancer each year, and more than 40,000 die, according to the American Cancer Society. Deaths from breast cancer have declined steadily since about 1990, thanks to better detection and treatment, the study authors said. …

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