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Task Force Member Defends Mammography Guidelines
Date:11/19/2009

hing its recommendations, the task force of doctors and scientists determined that early and frequent mammograms often lead to false-positive readings and unnecessary biopsies, without substantially improving the odds of survival for women under 50.

Reaction to the proposed guidelines has been swift.

Critics such as the American Cancer Society vowed to stand by its advice that annual screening begin at age 40 for women of average risk. The American College of Radiology agreed.

But what will doctors who see female patients day after day suggest they do?

The guidelines recommend that women aged 40 to 49 and at average risk for breast cancer talk to their doctor about when it would be best for them to begin mammography screening. Those aged 50 to 74 should have every-other-year screenings, rather than an annual mammogram, according to the new guidelines. As for women aged 75 and older, the task force concluded that there is not enough evidence to assess the benefits and harms of the test.

Whether they agree or disagree with the guidelines, experts seem to agree that women should talk to their health-care providers for guidance based on their individual medical history and other factors.

Three such providers -- an internist, a family physician and a gynecologist -- weigh in on what they will advise their patients to do.

An Internist's View

"The evidence supports the recommendation," said Dr. Karla Kerlikowske, director of the Women Veteran's Comprehensive Health Center at the San Francisco Veterans Affairs Medical Center, who wrote an editorial accompanying publication of the guidelines in the Annals of Internal Medicine.

"I think for women 40 to 49, we should target women who are at high risk," she said, such as those with a first-degree relative with breast cancer.

Changing the screening interval from annually to every two years for women 50 to 74, she sa
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