Breast cancer screening update.

The US Preventative Services Task Force convened to re-examine the available data regarding screening mammography for breast cancer and released their recommendations this week. Screening is recommended starting for women at age 50 and continuing up to age 74 for biannual mammograms. Here the data was graded a “B” meaning that there is a high certainty for a moderate overall benefit related to the service. For women age 40 to 49 the decision to screen should be an individual one based on circumstance and preference. The recommendation here was given a “C” grade meaning that there is a high certainty for a small overall benefit to the service. The decision to screen women age 75 and older remains indeterminate. The recommendations for all 3 age groups are unchanged from 2009. (For more on why the benefit is only small to moderate see my post from 12/04/15.)

Under the Affordable Care Act mammograms are considered preventative services and remain “free” (although nothing is really free, the cost merely uploaded into the premium price you pay each month). Congress has sided in favor of early screening and last month preemptively directed insurers to ignore the USPSTF’s recommendations and to cover screening per previous guidelines dating back to 2002. This was done to avoid backlash from advocate groups who vigorously protested the task force’s recommendations when they were first released in 2009. Emotion prevailed over science, then as now. We don’t rely on 14-year old recommendations in other areas of medicine, and I don’t think we should here either. One thing is certain: When multiple academic groups come to different conclusions, there is room for discussion. The decision to pursue screening should be made by you and your doctor.

Mammography Recommendations

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