Cites concerned that confusing, flawed guidelines could result in women losing access to life-saving annual mammograms
HOUSTON — Synergy Radiology Associates (SRA), the largest private radiology practice in the Houston metropolitan area, said it supports annual screening mammography for breast cancer starting at age 40, in agreement with most professional medical society guidelines. Furthermore, the radiology group supports the Protecting Access to Lifesaving Screenings Act (PALS Act). The federal legislation would delay proposed U.S. Preventive Services Task Force (USPSTF) recommendations against annual screening mammograms for women age 40 to 49.
The radiology group’s announcement comes in the wake of recently updated American Cancer Society (ACS) guidelines that said women could wait until age 45 to start annual breast cancer screening. That’s contrary to American College of Radiology (ACR), Society of Breast Imaging (SBI), American College of Obstetricians and Gynecologists (ACOG) and other major medical organization guidelines. The ACR and SBI jointly support passage of the PALS Act.
SRA radiologist Reena Vashi, M.D., is concerned about the mixed messages being sent to women, health care providers and insurance companies, which increase the possibility of women losing access to life-saving mammograms.
“Let’s clear up the confusion: getting a mammogram once a year, every year, starting at age 40 is the best way to decrease a woman’s risk of dying from breast cancer,” said Vashi, who is subspecialty trained in breast and body imaging and serves as chair of the Breast Program Leadership Committee at Clear Lake Regional Medical Center. “The goal of mammography is to detect breast cancer at the earliest stage, when it is the most treatable. All major professional medical organizations, including the ACS and USPSTF, agree that screening mammography between age 40 and 50 saves lives.”
Critics of annual screening mammograms raise concerns about potential harms of annual screening before age 45, including overdiagnosis, false alarms and increased anxiety. Vashi and others say the clinical data overwhelmingly supports the fact that the benefits of screening and early detection outweigh the potential harms in the 40-to-50 age group, while the USPSTF ignores recent science that shows annual screening mammography to be far more effective than older studies that were considered by the task force.
“Not a single major professional organization recommends against annual screenings in this age group, and overdiagnosis is a misnomer,” explained Vashi. “As radiologists, our responsibility is to use the best evidence-based screening guidelines to accurately detect and diagnose breast cancer, and it starts with screening at age 40.”
The ACR, SBI and ACS all agree that overdiagnosis claims are vastly inflated due to flaws in numerous clinical trials, and any overdiagnosis that does occur is primarily due to one particular type of cancer called ductal carcinoma in situ (DCIS). In fact, very few invasive cancers are overdiagnosed, and no evidence shows that an invasive cancer has ever gone away or has shrunk without treatment. Additionally, new technologies such as 3-D digital mammography (tomosynthesis), also ignored by the USPSTF, are helping to decrease false alarms even further while achieving a higher cancer detection rate.
“We are committed to providing our patients with the highest caliber radiology services available, and that includes following the most widely accepted breast cancer screening guidelines that provide the most benefit and will save the most lives,” said SRA President Walid Adham, M.D. “While well-intentioned, the ACS guidelines have been oversimplified in news reports and have, along with recent USPSTF actions, had the effect of confusing the issue of annual screening mammograms.”
More information about breast cancer screening facts and guidelines is also available at the ACR’s Mammography Saves Lives website.