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Studies Question Mammography Guidelines

May 3, 2011
Written by: , Filed in: Breast Imaging
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Several new studies explore the effects of the controversial screening mammography guidelines that were promulgated in November 2009 by the U.S. Preventive Services Task Force—especially the recommendation against routine screening for women in their 40s.

HealthImaging.com reports on three papers presented this week in Chicago at the annual meeting of the American Roentgen Ray Society:

  • Researchers at the University of Colorado in Denver surveyed 303 primary-care physicians and found statistically significant decreases in the number of screenings they ordered for women in their 40s after the 2009 guidelines were released. The guidelines recommend that women in that age group receive mammograms only if their physicians deem the procedure useful.
  • A second study from the same university found that fewer women in their 40s sought screening mammograms after the guidelines release.
  • A retrospective study at Case Western Reserve University in Cleveland indicates that among women in their 40s diagnosed with invasive breast cancer, those who had not had screening mammograms suffered from more advanced cancer.

Last week, research presented at the annual meeting of the American Society of Breast Surgeons in Washington, DC, suggests that excluding women in their 40s from annual screening mammograms would reduce the chances of survival among breast-cancer patients in that cohort.

Again according to HealthImaging.com, researchers at the University of Missouri at Columbia conducted a 10-year retrospective study of 1,581 women treated for breast cancer from 1998 through 2008 at the Ellis Fischel Cancer Center at the University of Missouri School of Medicine. Of those women, 20 percent were in their 40s.

The study found that mammography detected smaller tumors with less nodal metastasis than clinical breast exams were able to do. In other words, the cancer was at an earlier stage.

The researchers estimated the five-year disease-free survival rate was 94 percent for those who had received screening mammograms and 78 percent for those who had not.

Said researcher Paul Dale, MD, chief of surgical oncology at the cancer center:

Breast cancer has a better prognosis when treated before tumors become palpable and identifiable through a physician or self breast exam. The study also found that tumors identified through mammography generally had better outcomes after treatment than those found through clinical exams.

Related seminar: Breast & Women’s Imaging Seminar

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