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Do Yearly Mammograms Save Women's Lives?

Controversial new recommendations on breast cancer prevention have caused a stir in the women's health community. But do yearly mammograms really change death rates?

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It will take some time for the public and practitioners to really digest the Preventative Task Force's mammography recommendations. The Mayo Clinic, for example, an organization that prides itself on using comparative effectiveness studies to drive clinical practice, characterized the new guidelines as "interesting" but Dr. Sandhya Pruthi, director of the Mayo Clinic Breast Clinic, said "the current practice is to continue with annual screening mammography for women over age 40."

Some practitioners say that the recommendations should be used as a starting point for deeper conversations between women and their doctors about what makes the most sense for them personally. Screening, like treatment for breast cancer, is not a one-size-fits all endeavor. If a woman has a genetic propensity for breast cancer, has close family members who have been diagnosed with the disease or has already had a bout with cancer, she will probably want to receive regular screening, even in her 40s. But for the rest of us, our risks and benefits need to be carefully reconsidered depending on age, lifestyle and comfort level with the stress of false positives, for example.

In the end, the Preventative Task Force mammography recommendations are supported by strong data and good science. The study authors do not have conflicts of interest and despite charges from some critics, they are not connected to the government and did not have rationing of health care resources as their underlying mission. Therefore it seems short-sighted and counter-productive for groups like the American Cancer Society to so forcefully dismiss the recommendations out of hand. Instead, why not use them as the first step in advancing a changing view of breast cancer screening and the real risks and benefits involved. It's only by accepting these shortcomings that we can truly focus on developing better methods for detecting early tumors, better methods for distinguishing lesions that will progress from those that won't, and eventually, giving women a better "safety belt" to use against the threat of breast cancer.

Naomi Freundlich is a patient advocate at the Century Foundation who writes regularly for HealthBeat.