• American College of Radiology (2012)
• American Society of Breast Surgeons (2011)
The U.S. Preventive Services Task Force (2009) and the American Association of Family Physicians (2012) recommend women 40 to 49 make an individual decision about screening with their doctors. Those concerned about breast cancer should get screening every one to two years while in their 40s. These two organizations recommend screening every two years from 50 to 74.
Most of these organizations have statements that women should be informed of the limitations of mammography, including:
• Screening is a better test for women in their 50s and 60s versus women in their 40s.
• Screening will have some false alarms. Some women will be told they have a finding that requires further testing. Most of these women will ultimately not have cancer.
• Screening will miss some important cancers we wish it would find.
• Screening will find some cancers that do not need treatment and cause some women to get unnecessary treatment.
• There is a small long-term risk of radiation-induced breast cancer.
I am concerned that we in American medicine have led many to believe breast screening is better than it is. That is not to say it should not be used -- it should be used with caution. Women should be informed of the benefits and limitations of mammography and clinical breast examination, and we need to work hard to find a better test.