Tag: Liane Philpotts

New Breast Cancer Screening Guidelines Could Backfire

Lianne PhilpottsLast week the American Cancer Society (ACS) released new breast cancer screening guidelines. There has been mixed reaction to these guidelines, which recommend less screening – mammography starting at a later age (45 years old) and less frequent (every two years after age 55). Those who are mammography skeptics applaud this ‘less is more’ approach. But those who feel early detection is the best way to prevent deaths from breast cancer, are defending that annual mammography from age 40 on is best. Yet another battle in the mammography war has started!

With the increased emphasis on personalized medicine, the new guidelines can be viewed as a small step in that direction. Not a ‘one-size-fits-all’ recommendation, but tailored to the patient’s age. This is reasonable. Yet the ACS acknowledges that annual screening yields a better mortality reduction than biennial and that all women over 40 should have access to annual mammograms. How is that going to work? Guidelines are supposed to guide – these leave it up in the air.

What are breast imagers supposed to tell the over-55 patients? Come back in 1… or 2 years? Or not give any recommendation and leave it up to the patient and her physician to decide? What are the medico-legal ramifications? If a woman over 55 who adheres to biennial screening feels she could have had her cancer detected earlier, will she sue her doctor for not recommending annual? Will most women and physicians really have an in-depth discussion of the risks and benefits of screening on an individual level? The responsibility on the referring physicians will be great.

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