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Guidelines Delay Start of Mammograms to Age 50, Then Every Other Year
Date:11/16/2009

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  • Recommend that women aged 50 to 74 years old have screening mammograms every other year rather than annually.
  • Say that not enough data exist to make a recommendation based on benefits vs. harms for women 75 and older.
  • Recommend against teaching women breast self-examination because the evidence does not show it reduces deaths from breast cancer.
  • Say that not enough evidence exists to assess the value of clinical breast exams done by a health-care provider for women aged 40 and older.
  • What triggered the changes?

    "Every topic [of preventive health] comes up for re-review every five years," said Dr. Diana Petitti, vice chairwoman of the task force and associate director of the Center for Health Information and Research at Arizona State University, Phoenix. "The task force issued its last recommendation about breast cancer screening in 2002."

    She said the task force reviewed published evidence of five screening modalities in reducing breast cancer death: traditional film mammography, clinical breast exam, breast self-exams, digital mammography and MRI. The task force also commissioned two studies related to breast cancer screening, Petitti said.

    The results, published in the Nov. 17 issue of the Annals of Internal Medicine, did not include a recommendation favoring one form of mammography or MRI over another.

    The American Cancer Society and the American College of Radiology have indicated strong disagreement with the new guidelines.

    Dr. Otis W. Brawley, chief medical officer of the American Cancer Society, said in a statement that the organization "continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40."

    Before the cancer society made that recommendation, Brawley noted, its experts considered "virtually all the same data reviewed by the [task force], but also additional data t
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