Breast Screening Guidelines Position Statement

TACOMA, Wash.—Following is The Carol Milgard Breast Center’s response to the U.S. Preventive Services Task Force guidelines issued November 16, 2009.

The US Preventive Services Task Force suggested women in their 40s should stop having mammograms until they are 50 and then have an exam every other year. The study released shows mammograms continue to be an effective tool for cancer detection in women 50-74 years old. The data for women 40 – 50 years old is less clear however, there are significant studies that have shown the benefit of screening mammograms in this age group.

After reviewing the study released by the federal task force, the Carol Milgard Breast Center joins the following groups in their stand and current guidelines:

• National Cancer Institute
• Society of Breast Imaging
• American Cancer Society
• American College of Radiology
• Susan G. Komen for the Cure
• Seattle Cancer Care Alliance

Constance D. Lehman, MD, PhD, for the American Cancer Society Breast Cancer Advisory Group states: “Women need a clear message: early detection offers a woman the best chance for a cure, and mammography is essential for early detection of breast cancer… In fact, according to the ACS, 17 percent of breast cancer deaths in 2006 were among women who were diagnosed between ages 40 and 49.”

“We know that digital mammography significantly improves the detection of cancer in younger women and in women with dense breast tissue. These well-documented facts are not included in the analyses that led to the change in the recommendations. It is important that women receive their mammograms at centers with the ability to provide high quality exams and that all women understand the importance of mammography for the early detection of breast cancer.”

“Failing to identify those women in their 40s with cancer and having them wait until they are screened at age 50 is a disservice. By then breast cancer can be advanced and more difficult to treat.”

We, at the Carol Milgard Breast Center, are dedicated to the early detection of breast cancer and are in complete agreement with the American Cancer Society guidelines:

• Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
• Clinical breast exam (CBE) should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for women 40 and over.
• Women should know how their breasts normally feel and report any breast change promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s.
• Women at high risk (greater than 20 percent lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15 percent to 20 percent lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15 percent.

The Carol Milgard Breast Center will continue to follow the above widely recognized recommendations. In addition, we suggest women consider their individual benefits and risks and discuss them with their health care provider before making the decision to follow the controversial changes in the government’s recommendations.