Breast Care Experts Come Out Against Mammogram Guidelines

By Sheilah Downey

Most healthcare experts have vehemently decried the mammogram guidelines issued this week and are urging women, and the insurance industry as well, to ignore the panel's recommendations.

The former head of the National Institutes of Health today advised women to ignore the government task force guidelines which recommended mammograms aren't needed until the age of 50, and that breast self-exams are worthless.

"I'm saying very powerfully ignore them," said Dr. Bernadine Healy on Fox News Sunday. "This will increase the number of women dying of breast cancer."

Joining the thumbs down crowd about the Task Force recommendations were the American Cancer Society, the American College of Radiology, and the National Institutes of Health.

Members of the Task Force defended their stance, saying they weighed the benefits and risks of their recommendations using the latest scientific evidence, said Dr. Diana Petitti, vice chairwomen of the task force.

"At 50, the balance of benefits and harm [from mammography] become better," she said.

Petitti said the task force looked at published evidence of five screening models in reducing breast cancer deaths and also commissioned two studies related to breast cancer screening. The task force said anxiety over false positives in mammograms and overtreatment were harms of mammography.

Dr. Carol Lee, chair of the American College of Radiology Breast Imaging Commission, called the recommendations "incredibly flawed," and said they were based on conflicting computer models and "unsupported and discredited ideas."

"Without a doubt, the possibility of having one's life saved through early detection far outweighs any of these concerns," said Dr. Lee. "Their premise is tragically incorrect and will result in many needless deaths if their recommendations are adopted by the American public."

Since the onset of mammography screening in 1990, said Lee, the mortality rate from breast cancer has decreased by 30 percent.

 She said the task force recommendations seem to reflect a decision to "ration care," and said if Medicare and other insurance companies abide by the suggestions "it could have deadly effects for American women."

Dr. Otis Brawley, chief medical officer of the American Cancer Society,  also questioned the validity of the task force's scientific evidence.

He said the ACS looked at "virtually all the same data reviewed by the task force but also additional data that it did not consider."

The ACS "continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40," said Dr. Brawley.

Health and Human Services Secretary Kathleen Sebelius also came out against the panel's recommendations this week saying that while new evidence was presented "our policies remain unchanged."

"There is no question that the U.S. Preventive Services Task Force recommendations have caused a great deal of confusion and worry among women and their families across this country," said Sebelius.

Sebelius said it was highly unlikely that insurers would adopt the panel's recommendations as part of their plans because the Task Force does not set policy.