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More Studies Show That Mammogram Rates Have Dropped After Task Force Recommendations, May Lead to Missed Diagnoses

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Research has found that fewer women are getting screening mammograms since the U.S. Preventive Services Task Force (USPSTF) recommended that screening mammograms start at age 50 instead of age 40 for women with an average risk of breast cancer. Fewer women being screened may lead to breast cancer going undetected.

The USPSTF recommendations also said that women age 50 to 74 could have screening mammograms every other year and that women older than 74 didn’t need screening mammograms. These recommended changes were very controversial and were NOT adopted.

The studies were presented at the 2012 Annual Meeting of the Radiological Society of North America. Read the abstracts of “Digital Mammography Screening for Patients in Their Forties in New York City (2007-2010): A Retrospective Study Examining the Potential Impact of the USPSTF’s Changed Recommendations for Breast Cancer Screening” and “The Effect of the U.S. Preventive Services Task Force Recommendation on Use of Screening Mammography.”

To analyze mammogram rates among older women, the researchers looked at about 17 million Medicare Part B records.

Until 2010, screening mammogram rates had been steadily going up about 1.4% per year since 2001, the researchers found. But for women on Medicare, there was a 4.3% drop in screening mammogram rates in 2010 – the year after the USPSTF recommendations were announced:

  • 309.1 per 1,000 eligible women had mammograms in 2010
  • 322.9 per 1,000 eligible women had mammograms in 2009

To analyze the effectiveness of screening mammograms among women age 40 to 49, the researchers looked at information on screening mammograms done at New York Presbyterian Hospital between 2007 and 2010. During those 4 years, more than 43,350 screening mammograms were done, which led to the detection of 205 breast cancers:

  • 14,528 women (33.5%) were between the ages of 40 and 49
  • of the 205 cancers detected, 39 (19%) were found in women age 40 to 49; more than 50% of these cancers were invasive
  • only three women age 40 to 49 diagnosed with breast cancer had a first degree relative diagnosed with premenopausal breast cancer

This means that if the USPSTF recommendations had been followed, 20% of the cancers found would have been missed because women age 40 to 49 wouldn’t have been getting screening mammograms. The researchers and believe that this is unacceptable.

If you're 40 or older and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. If your breast cancer risk is higher than average, you may want to talk to your doctor about a more aggressive breast cancer screening plan that makes the most sense for your particular situation.

The Mayo Clinic, the American Medical Association, the American College of Obstetricians and Gynecologists, the American College of Radiology, the American Cancer Society, the National Cancer Institute, and the National Comprehensive Cancer Network all recommend that screening mammograms should start at age 40.

There's only one of you and you deserve the best care possible. Don't let any obstacles get in the way of your regular screening mammograms.

  • If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
  • If you're having problems scheduling a mammogram, call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
  • If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.

For more information on mammograms and other tests to detect and diagnose breast cancer, visit the Screening and Testing section.

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