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Breast cancer

24 June 2010

Expert Challenges New Mammogram Guidelines

Screening should start at age 40, not 50 as U.S. task force recommends, Harvard radiologist says

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"We know from the scientific studies that screening saves a lot of lives, and it saves lives among women in their 40s," said Dr. Daniel B. Kopans, a professor of radiology at Harvard Medical School and senior radiologist in the breast imaging division at Massachusetts General Hospital in Boston.

  • The guidelines cite research that shows mammograms are responsible for a 15 percent reduction in mortality. That's an underestimate. Other studies show screening women in their 40s can reduce deaths by as much as 44 percent.
  • Sparing women from unnecessary worry over false positives is a poor reason for not screening, since dying of breast cancer is a far worse fate. "They made the subjective decision that women in their 40s couldn't tolerate the anxiety of being called back because of a questionable screening study, even though when you ask women who've been through it, most are pleased there was nothing wrong, and studies show they will come back for their next screening even more religiously," Kopans said. "The task force took the decision away from women. It's incredibly paternalistic."
  • The task force recommendation to screen only high-risk women in their 40s will miss the 75 percent of breast cancers that occur among women who would not be considered high risk, that is, they don't have a strong family history of the disease and they don't have the BRCA1 or BRCA2 genes known to heighten cancer risk.

 

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Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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