Evolution of mammo recommendations will help to alleviate confusion

Earlier this month ABC News correspondent Amy Robach announced that she has breast cancer and will undergo a double mastectomy.

Breast cancer diagnoses, in and of themselves, aren't unusual. But, in Robach's case, it had particularly significance, as her diagnosis was only revealed after she reluctantly agreed to undergo a mammogram during a live episode of Good Morning America.

Robach also is just 40 years old and has little history of breast cancer, which means that had she followed the United States Preventive Services Task Force (USPSTF) 2009 guidelines for screening, it is likely she wouldn't have undergone her first mammogram until a decade later.

Coincidentally, last week the USPSTF unveiled a draft research plan it will use to guide what it calls a "systematic review" of evidence on breast screening. A resulting evidence report will form a USPSTF Recommendation Statement on the subject.

According to the USPSTF, among the key issues being considered is the effectiveness of regular mammography screening for women 40 and over as it relates to reducing breast-cancer specific and all-cause mortality. The USPSTF also plans to look at the harms of routine mammography--such as anxiety caused by false positives, or the physical, emotional and financial cost of unnecessary biopsies--and how they differ by age and risk factor. Additionally, it plans to look at mammography screening effectiveness by alternative modalities, such as MRI and 3-D procedures.

Since USPSTF came out with its 2009 mammogram recommendations, we've seen researchers dueling one another with back-and-forth studies on the efficacy of breast cancer screening. Because the issue is so important, we should welcome any effort by the USPSTF to review the topic.

In the meantime, Robach's situation reminds us that the issue remains somewhat confusing for women who are intimately affected by such debates. After all, when different experts are touting different screening recommendations--unlike the USPSTF, the American Cancer Society recommends annual screening for women 40 and over--what are patients to think? - Mike (@FierceHealthIT)

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