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Elizabeth Arleo, assistant professor of radiology at Weill Cornell Medical College
Arleo

Studies question revised mammography guidelines


By Jaimy Lee
Posted: November 27, 2012 - 2:45 pm ET
Tags:

The revised mammography screening guidelines issued by the U.S. Preventive Services Task Force three years ago may result in missed cancers and declines in screening, according to two studies presented at the Radiological Society of North America's annual meeting this week in Chicago.

Both studies looked at changes in mammography screening data following the task force's controversial recommendations in 2009.

The U.S. Preventive Services Task Force said women should begin routine screening at age 50, instead of age 40. The guidelines also recommended that women undergo routine screening every two years instead of every year and routine screening should end when women are 74 years old.

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Almost 20% of breast cancers detected during routine screening between 2007 and 2010 were found in women in their 40s, according to the study conducted by Dr. Elizabeth Arleo, assistant professor of radiology at Weill Cornell Medical College.

“It seems unacceptable to potentially miss nearly 20 percent of the breast cancers we are identifying,” Arleo said in an RSNA news release. “This, in our view, would represent a substantial degree of under-diagnosis.”

Dr. David Levin, professor and chairman emeritus of the radiology department at Thomas Jefferson University Hospital, conducted a separate study of Medicare beneficiaries.

That study found the mammography screening utilization rate fell 4.3% from 2009 to 2010, which was the first year that data was available after the task force's recommendations. The compound annual growth rate for mammography screening utilization was 0.9% from 2005 to 2009.

“We're not able to tell from the data whether this significant drop in utilization was a result of women deciding to wait another year to have their mammogram, or women over the age of 74 not having the exam,” Levin said in the same news release. “But, clearly, the new USPSTF guidelines have had an effect.”

Researchers at last year's meeting also presented a study that went against the task force's recommendations. That study said women in their 40s with no family history of breast cancer would benefit from annual mammography screenings.

Three other studies relating to breast cancer and radiology were presented today at RSNA.

One study found that radiation doses during mammography are negligible or very low, and do not result in an increased risk of cancer. In addition, the study said that thyroid shields during mammography are unnecessary.

Another study found that certain patients, such as younger women and those who have received repeat CT scans, could have a higher risk of breast cancer from increased CT utilization that occurred from 2000 to 2010.

A third study found that a majority of women who have been notified that they have dense breast tissue would pay between $300 and $500 in out-of-pocket costs for additional screening options.


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