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Women in their 40s should stop routinely having annual mammograms and older women should cut back to one scheduled exam every other year, an influential federal task force has concluded, challenging the use of one of the most common medical tests.
In its first reevaluation of breast cancer screening since 2002, the independent government-appointed panel recommended the changes, citing evidence that the potential harm to women having annual exams beginning at age 40 outweighs the benefit.
Coming amid a highly charged national debate over health-care reform and simmering suspicions about the possibility of rationing medical services, the recommendations immediately became enveloped in controversy.
"We're not saying women shouldn't get screened. Screening does saves lives," said Diana B. Petitti, vice chairman of the U.S. Preventive Services Task Force, which released the recommendations Monday in a paper being published in Tuesday's Annals of Internal Medicine. "But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully."
Several patient advocacy groups and many breast cancer experts welcomed the new guidelines, saying they represent a growing recognition that more testing, exams and treatment are not always beneficial and, in fact, can harm patients. Mammograms produce false-positive results in about 10 percent of cases, causing anxiety and often prompting women to undergo unnecessary follow-up tests, sometimes-disfiguring biopsies and unneeded treatment, including surgery, radiation and chemotherapy.
But the American Cancer Society, the American College of Radiology and other experts condemned the change, saying the benefits of routine mammography have been clearly demonstrated and play a key role in reducing the number of mastectomies and the death toll from one of the most common cancers.
"Tens of thousands of lives are being saved by mammography screening, and these idiots want to do away with it," said Daniel B. Kopans, a radiology professor at Harvard Medical School. "It's crazy -- unethical, really."
The new guidelines also recommend against teaching women to do regular self-exams and concluded that there is insufficient evidence to recommend that doctors do the exams or to continue routine mammograms beyond age 74...
While annual mammography for all women beginning at age 40 reduced the death rate from breast cancer by at least 15 percent, the modeling studies indicated that the added benefit of starting before age 50 was modest, the researchers concluded.
For every 1,000 women screened beginning at age 40, the modeling suggested that just about 0.7 deaths from breast cancer would be prevented, while about 470 additional women would receive a false-positive result and about 33 more would undergo unnecessary biopsies.
What? I thought we were going to save billions of dollars with preventive medicine under Obamacare, now they don't even want women to bother with self-exams? When a woman reaches 74 does her risk of breast cancer just disappear? Is your grandma or that one in a thousand woman under 50 not worth saving? How does health care 'modeling' work, is it anywhere near as accurate as climate change 'modeling?'