When it comes to mammograms, not only can reasonable minds disagree, they can all legitimately do so while arguing for the greater good. One would think ... The U.S. Preventive Services Task Force has recommended against regular mammograms for women under the age of 50 — and to say that this recommendation was not universally endorsed or warmly received would be an understatement.
As today's Los Angeles Times article noted:
"Other groups that issue guidelines about screening and prevention, such as the American Cancer Society, the National Cancer Institute and the American College of Obstetricians and Gynecologists, immediately attacked the federal panel's conclusion, saying that they would not change their guidelines and would continue to urge women to undergo the tests."
For details on that official dissension, here's the statement from the American Cancer Society.
It says in part: "The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40. Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider."
Here's the full response from the American College of Obstetricians and Gynecologists.
And here's a widely held perspective from Kathleen Reardon, a USC professor and, not incidentally, a breast cancer survivor. She begins today's essay on the Huffington Post:
"I'd be dead by now if it weren't for breast self-examination. And had my doctor been less convinced of his own guidelines regarding women without a known history of breast cancer, my cancer would have been detected earlier and I would have been treated sooner and less aggressively. I was 32 years old."
The task force's concerns about the risk of false positives and biopsy complications are very real, but the defenders of the new recommendations have been relatively quiet — with a few notable exceptions.
There's this from Dr. Susan Love's blog: "The fact is the decision to change the age at which mammography screening begins in this country from age 50 to age 40 was always controversial and was never unanimously supported. That’s because mammography is not as good a tool in younger women."
Certainly, it could be argued that this is a fair statement from a reasonable mind. But some of the responses make clear why defenders of the recommendations might be reluctant to attempt to discuss the greater good.
— Tami Dennis
Photo: Mammograms of dense breast tissue, such as on the left, can be more difficult to interpret.
Credit: National Cancer Institute