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SCIENCEFriday 15 January 2016
Task force: Mammograms an option at 40, do more good at 50
L. NEERGAARD found. ports a range of options” their own choice. the University of California,
AP Medical Writer The advisory group wants for 40-somethings, LeFevre San Francisco. “Maybe we
WASHINGTON (AP) — Mam- younger women to under- said. “We’re moving away from should be screening in a
mograms do the most good stand the trade-offs before new way.”
later in life, a U.S. govern- deciding: Among every DIFFERING GUIDELINES paternalistic medicine Esserman leads the first-
ment task force declared 1,000 women screened, Mammograms aren’t per- of-its-kind WISDOM study
this week in recommending one additional death fect, and different health where we doctor organiza- that soon will begin enroll-
that women get one every could be prevented by organizations weigh the ing 100,000 women to test
other year starting at age starting mammograms at trade-offs differently. So tions used to tell women, whether tailoring screening
50. It said 40-somethings to someone’s individual risk
should make their own ‘You must do this,’” Braw- is better than age-based
choice after weighing the mammograms. Women
pros and cons. ley said. “We’re saying, given annual mammo-
When to start routine mam- grams starting at 40 will
mograms and how fre- ‘This woman is at higher be compared with others
quently to get them has assigned more or less fre-
long been controversial. risk, therefore maybe she quent screenings, starting
The latest guidelines from at different ages, based on
the U.S. Preventive Services should get screened at 40. in-depth risk assessments.
Task Force stick with its ad-
vice that women should This woman is at lower risk, INSURANCE COVERAGE
one every two years be- Insurance usually pays for
tween ages 50 and 74. But maybe she can wait a little mammograms. Because
they also make clear that of concern about how the
it’s an option for young- later.’” task force recommenda-
er women even though tions might be implement-
they’re less likely to benefit. The American College of ed, Congress recently ex-
Some health groups urge tended for two years leg-
mammograms every year Obstetricians and Gyne- islation preserving access
starting at 40 — although to routine mammograms
last year the American cologists stands by annual without copays starting at
Cancer Society upped its age 40.
starting age to 45. mammograms starting at
There is some common WHEN TO STOP
ground emerging, that 40, while urging patient The task force says more
mammography advice research is needed to
shouldn’t always be one- education and shared de- know whether to continue
size-fits all. “Age 50 isn’t mammograms at 75 and
magic,” said task force cision-making. beyond. The cancer soci-
past chairman Dr. Michael ety says to keep screening
LeFevre of the University of A radiologist uses a magnifying glass to check mammograms THINGS TO CONSIDER as long as women are in
Missouri. for breast cancer in Los Angeles. Mammograms do the most More than 200,000 women good health and have a
Here are some things to good later in life, a government task force said this week in in the U.S. are diagnosed life expectancy of at least
know about mammo- recommending that women get one every other year starting with breast cancer each 10 years.
grams. at age 50, and that 40-somethings make their own choice after year, and about 40,000 die
weighing the pros and cons. from it. It is most frequently WHAT’S NEXT
WHAT THE TASK FORCE SAYS (AP Photo/Damian Dovarganes) diagnosed among wom- The task force said more
Women in their 60s are the en ages 55 to 64, and the research is needed to tell
most likely to avoid dying 40 instead of 50. But there do women and their physi- median age of death from if newer 3-D mammograms
from breast cancer thanks would be 576 more false cians. breast cancer is 68. should be used for routine
to mammograms, but alarms and 58 additional The American Cancer So- Screening guidelines are screening and if women
there’s clearly enough ben- unneeded biopsies. Also, ciety says to begin annual only for women at aver- with dense breasts benefit
efit for the average woman two extra women would be mammograms at 45 but age risk of breast cancer. from extra testing, such as
to start at 50, the task force overdiagnosed, treated for switch to every other year Women with a mother, sis- with ultrasounds or MRIs.q
cancer that never would at 55. After menopause, ter or daughter with breast
have become life-threat- tumors tend to grow more cancer have a higher risk
ening. slowly and women’s breast than the average 40-year-
Monday’s update, pub- tissue becomes less dense old. Other factors can play
lished in Annals of Inter- and easier for mammo- a role, too, including ge-
nal Medicine, is largely a grams to penetrate, says netics, breast density and
rewording of guidelines chief medical officer Dr. menstrual and pregnancy
originally issued in 2009 Otis Brawley. Between ages history.
and reconsidered in draft 40 and 44, when breast
form last spring. This time, cancer is especially un- PERSONALIZED SCREENING
the task force stresses that common, the society also Dueling guidelines mean
“we think thescience sup- says women should make “some people get so
confused they don’t get
screened at all. Some are
too anxious or afraid not
to do more, and it may
not be better for them,”
said breast cancer special-
ist Dr. Laura Esserman of
