U.S. study revives
argument over mammogram screening
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[August 21, 2017] By
Andrew M. Seaman
(Reuters Health) - Yearly mammograms
starting at age 40 would prevent the most deaths from breast cancer,
U.S. researchers reported on Monday in a challenge to more conservative
recommendations that take into account both the harms and the benefits
of screening.
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The study, led by Dr. Elizabeth Arleo, a radiologist specializing in
mammography at Weill Cornell Medicine and New York-Presbyterian,
found that yearly mammograms between the age of 40 and 80 could cut
breast cancer deaths by 40 percent.
That compares with a reduction of 23 to 31 percent with current
screening recommendations that call for less frequent screening
starting at an older age.
"Screening annually starting at age 40 is the best strategy to
prevent an early breast cancer death," said Arleo, whose study was
published in the journal Cancer.
The argument that annual mammograms save more lives is not new, said
Dr. Otis Brawley, chief medical officer of the American Cancer
Society.
Most groups, including the American Cancer Society and the U.S.
Preventive Services Task Force, a government-backed panel,
acknowledge that screening beginning at age 40 will catch more
breast cancers, but screening at this age also produces the most
false positive results.
The new study used data from computer models to compare the benefits
and risks of three screening regimens.
The model suggested yearly mammograms starting at 40 reduced breast
cancer deaths by 40 percent, compared with about 31 percent if all
women followed the ACS recommendations and 23 percent if they
followed the Task Force.
Yearly mammograms starting at 40 would also lead to the most women
being called back to doctors' offices for false alarms and biopsies
that turn out to be negative, the team found.
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Brawley said for a 40-year-old woman who starts mammography now, the
odds of having a false positive are "very high" while the odds that
the test will save your life "are very small."
That risk/benefit ratio begins to change around age 47 or 48, he
said, when the benefits of screening outweigh the risk of
overdiagnosis.
As a result, the American Cancer Society suggests yearly mammograms
starting at 45, and moving to every other year at age 55. The U.S.
Preventive Services Task Force recommends screening every two years
starting at age 50.
Both groups also recommend that women who are concerned about their
risk should be able to start screening earlier.
SOURCE: http://bit.ly/HwspDv Cancer, online August 21, 2017
(Reporting by Andrew Seaman in New York; Editing by Marguerita Choy)
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