Experts criticize new advice on mammograms-However expert said any chance of early detection is better than none.

Mammogram for elderly done annually as older women change increases in age.


The San Antonio Silver Stars' Helen Darling undergoes a mammogram as part of an awareness-raising event on cancer


US health authorities have issued guidelines questioning the benefit of annual screening for breast cancer in women aged 40-49 and recommended only biennial mammograms for women over 50.

In an update of its 2002 recommendations, the US Preventive Service Task Force (USPSTF) said "the decision to start regular, biennial screening mammography before the age of 50 years should be an individual one."

After examining data from 600,830 women who underwent routine mammographs between 2000 and 2005, the USPSTF concluded that there was "moderate evidence that the net benefit is small for women aged 40 to 49."

The study said screening for breast cancer in the 40-49 age group can often lead to misdiagnosis and unnecessary surgery, or can fail to detect the cancer altogether.

In an earlier survey, the USPSTF said that in 10 percent to 20 percent of women diagnosed with breast cancer the tumors were not detected by mammography.

In another 10-20 percent of women, the task force added, growths were misdiagnosed as malignant, or cancerous, when they were benign.

Breast cancer is the second-leading cause of death among women in the United States. In 2008, 182,460 women were diagnosed with invasive cancer, 67,770 with non-invasive tumors and 40,480 women died from the disease.

The chances of developing breast cancer are one out of 69 for women aged 40-50, one in 38 for women 50-60, and one in 27 for women 60-70.

Experts question motives of mammogram guidelines

Cancer experts fear new U.S. breast imaging guidelines that recommend against routine screening mammograms for women in their 40s may have their roots in the current drive in Washington to reform healthcare.

Critics of the guidelines, issued on Monday by the U.S. Services Task Force, an independent panel sponsored by the U.S. Agency for Healthcare Quality, say the new guidelines are a step backward and will lead to more cancer deaths.

Here are some of their concerns.

* Dr Carol Lee, chairwoman of the American College of Radiology Breast Imaging Commission, said she fears insurers -- both private and public -- will use them to pare back health costs.

"These new recommendations seem to reflect a conscious decision to ration care," Lee said in a statement.

She said since the onset of regular mammogram screening in 1990, the death rate from breast cancer, which had been unchanged for the preceding 50 years, has decreased by 30 percent.

* Dr Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, said the influential group will not change recommendations for routine mammograms for women starting at age 40.

But he is worried that women will become so confused by the conflicting recommendations they will stop getting mammograms altogether. "Frankly, from our point of view that would be the worst possible outcome," Lichtenfeld said in a telephone interview.

* Lichtenfeld and other doctors are worried that insurance companies and government insurers will seize on the recommendations as a way to control rising health costs.

"What is going to happen is insurers are going to say, 'The U.S. Preventive Services Task Force doesn't support screening. We're not going to pay for it,'" said Dr Daniel Kopans, professor of radiology at Harvard Medical School and a senior radiologist at Massachusetts General Hospital in Boston.

"There were no new data to assess. One has to wonder why these new guidelines are being promulgated at a time when healthcare is under discussion and I am afraid their decision is related to saving money rather than saving lives," Kopans said.

* "The USPSTF recommendations are a step backward and represent a significant harm to women's health," Dr W. Phil Evans, president of the Society of Breast Imaging, said in a statement.

"At least 40 percent of the lives saved by mammographic screening are of women aged 40-49. These recommendations are inconsistent with current science and apparently have been developed in an attempt to reduce costs. Unfortunately, many women may pay for this unsound approach with their lives."

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