SABCS 2009: Mammography Screening Controversy
Doctors and advocates at the 2009 San Antonio Breast Cancer Symposium chime in regarding the new mammography screening guidelines.
NARRATOR: For the first time in eight years, the government has released new guidelines for mammography screening. The U.S. Preventive Services Task Force recently reversed its position on screening mammography for women in their 40s and set a firestorm of controversy.
CNN TONIGHT BREAKING NEWS: For more on our breaking news story for tonight, the controversial new guidelines for breast cancer screening.
ANDERSON COOPER 360, CNN: According to the U.S. Preventive Services Task Force, this is new, instead the government paneled doctors and scientists, none of which are oncologists, advises women to begin mammograms at age 50.
TOYA WASHINGTON, LOCAL NEWS: Recommendations over breast cancer screenings are sure to spark controversy. A group of experts is changing guidelines as to who should get mammograms and when.
ASSOCIATED PRESS: The government is issuing new mammogram guidelines that say women should wait until they are 50 years old to get their first breast cancer screening.
NARRATOR: The new guideline conflicts with the American Cancer Society and many advocacy groups.
MARGARET KIRK, CEO, Breast Cancer Network of Strength: I think the thing that surprised some people is while we as an organization do support and follow and urge and encourage evidence-based medicine absolutely, what we did was to come out with our statement, which was, “We are not changing our recommendations and our guidelines.”
NARRATOR: The potential risks of mammography include false-positive test results, false-negative test results, over-diagnosis. Over-diagnosis refers to diagnosis that will never cause health problems during the life of the patient and leads to unnecessary cancer treatment. World renowned breast doctor, Susan Love, shocked everyone when she came out in favor of the new guidelines.
DR. SUSAN LOVE: And in 1997, when we first started to talk about mammograms under 50 and had a consensus conference, the consensus was we shouldn’t do them under 50, but at that point there was a big outcry and Congress passed a nonbinding resolution and told the National Cancer Institute to come up with better guidelines, so these were never based on science.
NARRATOR: We recently spoke with several doctors at the San Antonio Breast Cancer Symposium about this issue.
ANDREA MCCARREN, HOST: What is your take on this firestorm of controversy about the recommendations for fewer mammograms, starting later…
JENNY CHANG, MD, Professor of Medicine, Baylor College of Medicine: It is true that you know, we pick up more cancers after the age of 50, but to be honest with you, younger patients are those who basically have more aggressive breast cancers and I personally started my mammograms at 35 for my first baseline and I have annual mammograms at 40.
ROWAN CHLEBOWSKI, MD, PhD, LA Biomedical Research Institute At Harbor-UCLA Medical Center: You won’t, will not get a debate from the American Oncologists.
GAD RENNERT, MD, PhD, Director, CHS National Cancer Control Center, Israel: The American policy makers have finally made the right policy. It took a lot of years of astonishment by most people who are experts in the field.
ROWAN CHLEBOWSKI, MD, PhD, LA Biomedical Research Institute At Harbor-UCLA Medical Center: Of all these, whatever, 9,000 – I don’t know how many would be oncologists, you know treating cancer patients but say 8,000 of them are oncologists treating cancer patients, everybody will have women in their 40s who would be dead if they didn’t have mammograms. And so the debate would be everybody, there would be 8,000 people on one side and there would be some people from the non-U.S. people on the other side saying, “Here’s the data. We’re saving some money and that’s good.” And I think that’s not the way we’re doing it. And I think that was a big signal from this healthcare business, “Well that’s what we’re going to be doing from now on.” But I think here, when you look at it, I think not too many medical oncologists are saying, “I think the women who are being diagnosed early, who are not dying of breast cancer, you know, should be on their own,”
GAD RENNERT, MD, PhD, Director, CHS National Cancer Control Center, Israel: I’m personally in charge of the National Breast Cancer Screening Program of Israel so I have a lot of, a lot to do with this specific subject, but practically every other country in the world starts mammography at 50 and does it every two years. The U.S. was the only one to officially start at 40 and do it every year. So the U.S. has joined the rest of the world on breast cancer screening policy, so congratulations.
NARRATOR: The bottom line is, educate yourself about the potential risks and benefits of screening, talk with your physician and make the decision that is right for you.
MARGARET KIRK, CEO, Breast Cancer Network of Strength: We believe women are smart enough, if they have access to the information they need and it’s credible, objective information, that they can make the best decision with their healthcare team.
