It’s been all over the news this week--the US Preventative Services Task Force came out with a new set of recommendations for breast cancer screening, including recommending against yearly mammograms for women ages 40-49.  Their recommendations say that there is only a small benefit from starting testing at 40, and that this benefit isn't enough to outweigh potential harms of testing, including psychological harms, unnecessary biopsies, and false positives.

The task force also recommends against teaching breast self-examination, another issue that raises controversy.  Alison wrote a post a couple months ago about whether breast self exams are beneficial, take a look to get a couple more viewpoints on the issue.

The main point is that starting routine mamography at age 40 doesn't save or add years to enough women's lives to recommend screening for everyone.  But mammography does sometimes detect cancer in women in their 40s, and these recommendations have many people worried that insurance may stop covering mammograms for women under 50.  Since the task force states, "the decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms," it seems unlikely that insurance companies will be able to refuse coverage for women whose physicians believe they should get earlier testing.  Women with a strong family history of breast cancer or with genetic mutations that predispose them to the disease will still be encouraged to start testing earlier.

Keep in mind that these recommendations aren't from some random group of government officials with no knowlegde of healthcare out to save money at the cost of peoples health; on the contrary, members of the task force include mostly physicians and professionals with degrees in public health and nursing from across the country.

If you want to see the details for yourself, you can take a look at the USPSTF recommendation summary itself, or articles from and the New York Times ).



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I would agree with the task force recommendations. Early mammograms in younger women are not as beneficial as once thought. Dr. Charles Simone, previous clinical associate in immunology/pharmacology at the National Cancer Institute, says "Mammograms increase the risk for developing breast cancer and raise the risk of spreading or metastasizing an existing growth." One thought is it’s due to the actually radiation from the x-ray machine. The American Cancer Society recognized only one cause of cancer, which is by radiation. Even with “low” amounts of x-rays, it quickly adds up considering the annual nature of mammogram screenings. An infrared thermography seems like a safer option. Thanks,

We talk about special interests lobbying of congress. What about the powerful insurance industry lobbying? It seems to me this is a result of insurance companies wanting to decrease their cost and increase their profitability!

One wonders at the effect of radiation from mammograms, if performed regularly and routinely, where there is no indication of lumps?

Does anyone know the status (good idea-bad idea) of thermography for screening? On its surface it sounds appealing, non-invasive, simple. But is it reliable? EDITOR's NOTE: check out our earlier blog on the topic: