Mammogram Screening: Test Offers Limited Benefits to Women Below 50

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The U.S. Preventive Services Task Force has finalized their advice about breast cancer screening, ending the controversy that has sparked debates since April 2015.

The newly-released guidelines are basically similar to those that the task force released earlier in 2009, Live Science reported. Task force chair Dr. Albert Siu, a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City, said that, since that time more agreements have been made by several groups including the American Cancer Society, the American College of Physicians and the American Academy of Family Physicians.

The task force has concluded that mammograms are effective. Their recommendations, published in the Annals of Internal Medicine, claimed that more benefits are received by women who get screened after turning 50. Thus, the task force has recommended that women who are 50 and older (up to 74) should be screened once every two years.

They also concluded that women aged 40-49 can undergo screening, albeit with fewer benefits and more risks. As such, women under 50 who would want to have mammograms should make individual decisions based on their knowledge of the possible risks and benefits that the procedure brings.

"Our recommendations support the entire range of decisions available to women in their forties," Kirsten Bibbins-Domingo, a physician and vice chair of the USPSTF, told NPR.

After reviewing new scientific evidences regarding mammograms, the task force has found that the number of breast cancer-related deaths prevented by screening is fewer for those screened under 50, but the number of false-positives and unnecessary biopsies are higher.

Task force statistical model estimates stated that, for every 1,000 screenings made for women younger than 50, one breast cancer death is averted. However, there are 576 additional false-positives, 58 additional benign biopsies and two additional overdiagnosed cases of breast cancer, compared to women screened after turning 50 year old.

The task force added that there's not enough evidence proving that women 75 or older still benefit from mammograms.

The American Cancer Society, however, suggested that women should start getting yearly mammograms at age 45 until 54 and then have it once every two years starting at 55.

Other groups, such as the National Comprehensive Cancer Network and the American College of Obstetricians and Gynecologists, recommended that average-risk women aged 40 should start getting mammograms yearly.

However, with all the confusion brought about by differing recommendations from different groups, it all boils down to making a personal informed choice, said task force chair Siu.

"Clinicians should understand the evidence but individualize decision making to the specific patient or situation,” Siu told MedPage Today.