The Confusion of Screening Mammography Guidelines

MINNEAPOLIS (KARE11), January 27, 2016 – Dr. Lisa Schneider, MD, CRL’s Breast Imaging Lead and Piper Breast Center Medical Director, sat down with KARE 11 News yesterday to discuss the confusion behind the latest screening mammography guidelines.

It’s understandable that women are confused about breast screening guidelines.  Earlier this month, the U.S. Preventive Services Task Force issued its final recommendations saying mammograms should be done every 2 years starting at age 50.  Those guidelines contrast with others.  The American Cancer Society suggests yearly mammograms starting at age 45. The American College of Obstetricians and Gynecologists says women aged 40 should start annual mammograms.

Dr. Lisa Schneider, a breast imaging specialist from Abbott Northwestern Hospital joined us in the KARE 11 studio with hopes of clearing up the confusion.

Dr. Schneider says the inconsistencies started earlier this month, when the U.S. Preventative Task Force released its final recommendation.  Revised guidelines from the American Cancer Society back in October of 2015 probably didn’t help either.  What’s interesting is that both organizations still agree that annual screening beginning at age 40 saves more lives than delaying screening until age 50 or less frequent screening (biennial vs yearly).

So what set of guidelines should women be following?  Dr. Schneider says the decision on whether to have a mammogram and when rests with each individual woman — ideally with input from her primary care physician.

Experts on breast cancer believe that mammography can detect cancers early. Early breast cancers are treatable and can be treated less aggressively. Since mammography screening was introduced in the U.S. in the 1980’s, the breast cancer death rate in the country has dropped by 35%.  The most benefit has been shown when women commence annual screening mammography at age 40.  Also consider that 1 in 6 breast cancers occur in women aged 40-49.

Something else to keep in mind, the majority of breast cancer, 75-85%, occurs in women who do not have risk factors.  If women would like more information regarding their risk factors, their primary care physician or obstetrician/gynecologist is a great place to begin the discussion.  The Piper Breast Center Abbott Northwestern Hospital and the Piper Breast Center of West Health both offer risk assessment and high risk screening clinics for breast cancer.

Dr. Schneider says the risks or harms of screening mammography are overblown. The radiation risk of a once a year screening mammogram is largely theoretical. There is no documented case of a woman developing breast cancer because of having regular screening mammography.  A lot of people do not know that mammography is a highly regulated area of medicine.  Any place in the US that performs screening mammography must undergo an annual inspection and pass this inspection. This was instituted with patient safety in mind.

As for the anxiety associated with women and mammography, a 2014 study published in the Journal of American Medical Association Internal Medicine found that women experience short term anxiety regarding test results but that it rapidly declines over time and there is no measurable effect to their health. Dr. Schneider says, “Part of my job is not just reading and interpreting a mammogram but to manage anxiety.”

So will the medical community ever come to a consensus about mammogram guidelines in the future?  Dr. Schneider says time will tell.  “Those of us who work with breast cancer patients and survivors of breast cancer on a daily basis are dedicated in allowing women access to regular screening mammography.”

For more information about breast cancer guidelines, Dr. Schneider suggests checking out this website: endtheconfusion.org.

Watch the interview here: KARE 11 Video

 

Story provided by KARE 11.