The American Cancer Society has issued new guidelines recommending less screening for breast cancer. The new guidelines suggest women should start getting mammograms at 45 instead of 40, and that women can skip the routine manual breast checks by doctors.
After a comprehensive review of the medical literature it was determined that these measures are not very effective. There are now three different recommended ages for starting mammograms from important cancer groups:
- the American College of Obstetricians and Gynecologists; 40
- the American Cancer Society; 45
- the U.S. Preventive Services Task Force; 50.
The new American Cancer Society guidelines also state that women over age 55 can choose to get a mammogram every other year, as breast cancers in post-menopausal women tend to develop more slowly. One important caveat, the updated guidelines are meant for women at average risk of breast cancer. Women with a family history or who carry a predisposing gene may need to start screening earlier and more frequently.
In regards to the new, less aggressive guidelines the question becomes, what is the downside to getting an early mammogram? Mammograms undoubtedly save lives when they catch cancer in its early stages. The main downside is that mammograms have a relatively high false positive rate causing some women to undergo painful tests to reveal they are cancer free. False positives are also more common for women under 45, as they have denser breasts and tumors are harder to spot on a scan.
Additionally, a mammogram could catch a very small breast cancer that will go way on its own or never prove harmful. Several reports discuss the spontaneous regression of cancer, including breast cancer. Yet, because doctors cannot dependably discern the harmful cancers from the harmless cancers they treat them all, unnecessarily exposing some women to harmful treatments, such as radiation, chemotherapy and surgery.
Several critiques were generated in response to the novel guidelines. Younger women whose breast cancers were caught by mammograms responded that they would “gladly risk a false positive, with all the inconvenient and sometimes painful followup, for the chance of finding cancer.”
Other criticisms disapproved the American Cancer Society’s review process for including studies of film mammography, which “in the United States has almost been entirely replaced by digital mammography. Digital mammograms generate clearer images and do a better job of finding cancer and have a lower false positive rate.”
Inevitably, insurance companies will for the most part determine at what age women get mammograms, although it is not clear whose guidelines they will follow.
At Rheingold Giuffra Ruffo Plotkin & Hellman LLP, we investigate and handle many cases involving the misdiagnosis of cancer. Partner, Thomas Giuffra, recently won a verdict for $2.5 million for a client who was incorrectly diagnosed with cancer. If you were incorrectly diagnosed or your diagnosis was caught late because of a doctor’s error contact us today online or by phone (212) 684-1880 to speak with a knowledgeable and experienced medical malpractice attorney.
