Why The New Mammogram Recommendation Doesn't Put Most Women At Increased Risk

This New York Times article gives the same scary media narrative repeated everywhere else in the past few days: Despite new recommendations that mo

This New York Times article gives the same scary media narrative repeated everywhere else in the past few days:

Despite new recommendations that most women start breast screening at 50 rather than 40, many doctors said Tuesday that they were simply not ready to make such a drastic change.

“It’s kind of hard to suggest that we should stop examining our patients and screening them,” said Dr. Annekathryn Goodman, director of the fellowship program in gynecological oncology at Massachusetts General Hospital. “I would be cautious about changing a practice that seems to work.”

The recommendations, issued Monday by a federal advisory panel, reversed widely promoted guidelines and were intended to reduce overtreatment. The panel said the benefits of screening women in their 40s — saving one life for every 1,904 women screened for 10 years — were outweighed by the potential for unnecessary tests and treatment, and the accompanying anxiety. Women considered at high risk should continue to have early screening, the panel said.

So I'm reading all these stories and saying, "Where's the data about the risk from radiation?"

I finally found this important (and missing) piece of the puzzle in the San Francisco Chronicle:

Radiation causes 1 death for every 2,000 women screened annually starting at age 40, according to a study published in 2005 in the British Journal of Cancer. Another study shows that each mammogram increases the risk of breast cancer by 2 percent. Mammography also saves women's lives, so that's why it's a trade-off.

Here's some more info from Respectful Insolence, a medical research blog.

Got that? Statistically, some women have approximately as much chance of getting breast cancer from a mammogram as they have of it saving their lives. That's why it's considered a policy wash.

Yes, you might be one of those rare women saved by early detection. But you might also be someone who develops breast cancer from the yearly radiation exposure.

By the way, the policy change recommendation doesn't apply to women with symptoms. It's for screening mammograms only, not the diagnostic kind.

UPDATE: Sebelius tells women to "ignore" the recommendation. How about we give women all the information - and let them decide?

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