Physicians from Stanford University, Stanford, Calif, stated at a community education program that it was too soon for patients and insurers to adhere to the new Federal guidelines for breast cancer screening.
As widely reported, the new guidelines, released in November by the U.S. Preventive Services Task Force (USPSTF), recommended that women with an average risk of breast cancer begin screening at age 50 instead of age 40.
Physicians at the Stanford forum, “Controversies in Screening for Women’s Cancer,” stated that they would continue to recommend patients follow the previous guidelines. The USPSTF said that the recommendations were partly in response to the stress and pain associated with false positive results.
Debra Ikeda, MD, director of Stanford University Breast Imaging, said in the press release, “Women need to know that [with routine mammograms] there may be false positives and a need for biopsies, but women should make that choice for themselves, with a doctor’s help.”
Professor of medicine-oncology, Robert W. Carlson, MD, stated in the forum that he is particularly concerned that the new guidelines could lead insurers to limit coverage of breast cancer screening.
Carlson also noted a large study that shows that breast self-exams can lead to more unnecessary biopsies and do not save more lives relative to a control group. Based on this evidence, Carlson said he no longer advises women to do breast self-exams, although he won’t discourage the practice if a woman wants to do it.
In conclusion, the program presenters predicted that the guidelines will likely be revisited as further evidence is collected. “It’s critical that we study this more and we study it carefully,” said program moderator Jonathan Berek, MD, director of the Women’s Cancer Program at Stanford, and professor and chair of obstetrics and gynecology.
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