"It's like dancing on the head of a pin," she said.
The question is not so much whether earlier mammograms save lives, but by how much.
The USPSTF crafted its 2009 statement based on an estimated 15 percent reduction in mortality in women aged 40 through 49 who underwent regular mammographies. Based on that, it predicted that 22.3 million mammographies would result in 156,000 call backs, almost 80,000 biopsies, 9,400 diagnoses of breast cancer and 1,175 lives saved each year, Brawley noted.
"The task force was overwhelmingly influenced by the number of women who would be called back and the number of biopsies that would be done," Brawley said, while also adding that it never actually recommended against screening in one's 40s.
"One could philosophically say that the real difference between the American Cancer Society and the USPSTF is that the ACS recommends women get screened but, in the second paragraph, be told of the potential risks and dangers of screening," Brawley said. "The task force recommends that women be told of the possible risks and benefits then says something to the effect of 'you can get it if you want it.'"
But Dr. Daniel Kopans, senior radiologist in the breast imaging division of Massachusetts General Hospital and a member of the American College of Radiology Breast Imaging Commission, feels it's "paternalistic if we don't think women can't deal with that kind of anxiety."
Mammography in your 40s clearly saves lives, he stated.
"The Swedish study, to me, should be the nail in the coffin [of the debate]," said Kopans, who is also a professor of radiology at Harvard Medical School. "This whole business of we don't know if works
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