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Controversy over frequency of mammograms for women continues

By Catholic Online (NEWS CONSORTIUM)
November 27th, 2012
Catholic Online (www.catholic.org)

The frequency of mammograms, a common medical procedure used to detect breast cancers and associated growths in women has become a hot topic for debate. One edict in 2009 says that women should have a mammograms ever two years instead of annually. New research says that a yearly mammogram is absolutely essential to detect breast cancer.

LOS ANGELES, CA (Catholic Online) - The U.S. Preventive Services Task Force of three years ago has come back to linger over a chilling new analysis published last week in the New England Journal of Medicine. The study, using 30 years of U.S. government data, found that nearly one in three patients, or 1.3 million women whose cancer was detected through routine mammograms was treated for a tumor that may not have been life threatening.

American Cancer Society has recommended screening for all women over the age of 40. While the society has not changed its stance, the task force issued new guidelines in 2009, recommending mammography every two years for women 50 to 74 years old.

Dr. Elizabeth Arleo of Weill Medical College of Cornell University and lead researcher examined the impact of the revised task force guidelines on women 40 to 49 years of age and 65 years and older. Arleo analyzed data on screening mammography at New York Presbyterian Hospital/Weill Cornell Medical Center between 2007 and 2010.

Over the course of those four years, 43,351 mammograms were performed, leading to the detection of 205 breast cancers. Nearly 20 percent of cancers detected with screening mammography were found in women in their 40s.

"In our book, it seems unacceptable to miss 19 percent of breast cancers, half of which were invasive," she said. "Invasive" cancers are more advanced as they reside in the breast tissues and not just the breast ducts.

"Our findings favor the American Cancer Society recommendations. Women over 40 should have annual mammograms. In my book, there's no confusion. I tell my patients, I tell my friends, and I tell my mother to get annual mammograms," Arleo said in an interview. "We hope we can quell some of the confusion."

Presenting her findings at the Radiological Society of North America meeting in Chicago, Arleo dismissed the NEJM analysis, calling the premise and conclusions of the analysis flawed. Arleo says this is mostly because no one can say for sure which cancers would have progressed to an advanced or life-threatening state.

"We need to understand the biology of cancer so we know which cancers to treat. Until that question is answered, screening is our best shot," she said.

She acknowledged that false positives are a problem of widespread screening.

"But for every test, you have to do a risk-benefit analysis, not just for mammography," Arleo added.

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