Network News - Winter 2009/2010 (PDF 3.7Mb - Canadian Breast ...

Controversy about
Mammography
Screening… Again
By Jackie Manthorne, Executive Director
Those of you who have been
involved in the breast cancer
community will know that every
so often, the value of mammography
and breast self-examination (BSE) is
questioned, much to the consternation
and often anger of women who
found their lumps by faithfully doing
BSE or through a regular screening
mammogram.
This time, it was the United States
Preventive Services Task Force
(USPSTF), which in November 2009
issued new recommendations:
“The USPSTF recommends against
routine screening mammography
in women aged 40 to 49 years. The
decision to start regular, biennial
screening mammography before the
age of 50 years should be an individual
one and take patient context into
account, including the patient’s values
regarding specific benefits and harms.
“In addition:
• The USPSTF recommends biennial
screening mammography for
women aged 50 to 74 years
• The USPSTF concludes that the
current evidence is insufficient to
assess the additional benefits and
harms of screening mammography
in women 75 years or older
• The USPSTF recommends against
teaching breast self-examination
(BSE)
• The USPSTF concludes that the
current evidence is insufficient to
assess the additional benefits and
harms of clinical breast examination
(CBE) beyond screening
mammography in women 40 years
or older
• The USPSTF concludes that the
current evidence is insufficient
to assess the additional benefits
and harms of either digital
mammography or magnetic
resonance imaging (MRI) instead
of film mammography as screening
modalities for breast cancer 1 “
Some of this we have heard before;
meta-analyses and studies have been
published and publicized in the last
few decades. Indeed, CBCN has
responded many times through its
own media releases and CBCN Board
presidents and other Directors have
been interviewed dozens of times
about these two issues.
On November 19, 2009, CBCN
issued the following media
release in response to the USPSTF
recommendations:
”Canadian Breast Cancer Network
speaks out against the finding of the
U.S. Preventive Services Task Force
(USPSTF) Recommendations on
Breast Screening
“Women from 40-49 should not
receive routine mammograms for early
detection of breast cancer according to
the U.S. Preventive Services Task Force
(USPSTF). The panel of doctors and
researchers, which does not include
oncologists, advises women to begin
regular screening every two years at
1 Screening for Breast Cancer
Recommendation Statement, US
Preventive Services Task Force,
http://www.ahrq.gov/clinic/uspstf09/breastcancer/brcanrs.htm
Network News Winter 2009-10 23