FHCI Responds to New Mammogram Guidelines

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The FHCI continues to support and follow the current American Cancer Society guidelines for screening mammograms. This includes regular mammogram screening starting at age 40 and includes self breast exams. In our own tumor registry, 23% of newly diagnosed breast cancer has been found in women under age 50, underscoring the importance of screening in the younger age group. We know screening has reduced mortality and encourage its continued use. 

The recent U.S. Preventive Services Task Force (USPSTF) report found enough evidence to support screening in women 50 to 69 years of age because the greatest survival benefit of mammography was found in this group. Mammography in the younger women had a lesser benefit. The report raised the concern of screening studies leading to additional tests including biopsies, and unfortunately emphasized the anxiety the false-positive results that may result. The review is based on older, film technology rather than the newer digital mammography with CAD. Upcoming technologies are being examined which should further reduce false positives and make screening even more effective. One of the criticisms of screening is that finding disease too early may not make any difference in the long run in our larger population studies. However, until we absolutely know which of these cancers can be ignored, we must continue to treat the patient as an individual.

We are concerned that the USPSTF guidelines may encourage the government and health care insurers to eventually no longer cover screening in the younger age group.

We must continue to be supportive of our patients, encourage using the current American Cancer Society guidelines that we believe are effective, and be ready to speak out on our patients' behalf.

Louis Barr, MD
Medical Director, Florida Hospital Cancer Institute