AMA Daily Excerpt: "Study: Biennial mammograms may be better for some women."
The following is from the AMA daily email. Bottom line on mammography is that it is more of an individual topic that should be discussed with your doctor. The recommendations and controversies surrounding recent research reports mandate that women discuss the benefits, and small but quantifiable risks, with their doctors to make an informed decision.
Research suggesting that annual mammograms may not be best for most women received a fair amount of coverage online, and was featured on two of last night's national news broadcasts. Most sources point to the fact that advice on mammogram frequency varies among medical groups, and that these findings back up recommendations from the US Preventive Services Task Force. Meanwhile, some sources mention that certain groups were critical of the study. The CBS Evening News (3/18, story 8, 2:30, Schieffer, 5.58M) reported that a new study has "found that doing mammography every two years rather than every year did not increase the risk of advanced breast cancer."
ABC World News (3/18, story 5, 2:05, Sawyer, 7.43M) reported that the study "revealed 60% of abnormal mammograms turn out to be false positives, not cancer at all, even though they can lead to biopsies, even surgery." During a second segment on the topic on ABC World News (3/18, story 6, 0:50, Sawyer, 7.43M), ABC's Dr. Richard Besser said, "I think this is one of the most important things you can do, with whatever serious illness you have. It's to ask this question. Say to your doctor, 'Before we go forward with any treatment, let's get a second opinion. And is there someone you can refer me to?' The best doctors are going to welcome another set of eyes, another way of looking at it."
CBS News (3/19) reports on its website, "The results, which were published on March 18 in JAMA Internal Medicine, follow the 2009 recommendation by the US Preventive Services Task Force that advocated for biennial mammography for women in this age group instead of the previous suggestion of getting screened every one to two years." In the new study, "the researchers looked at data from 11,474 women with breast cancer and 922,624 women without breast cancer who underwent screenings at US facilities involved in the long-running Breast Cancer Surveillance Consortium (BCSC) from January 1994 to December 2008." The researchers fond that "women who went every two years for a screening were not associated with an increased risk of advance stage breast cancers or large tumors, even if the woman had dense breasts or used hormone replacement therapies, when compared with women who were screened every year."
Bloomberg News (3/19, Cortez) reports, "The study found an exception for women 40 to 49 years old with extremely dense breasts." These individuals "were about twice as likely to be diagnosed with large tumors or advanced cancer if they skipped mammograms." Additionally, "they...had higher rates of false-positive results."
Reuters (3/19, Steenhuysen) reports, however, that some groups, including the American College of Radiology, criticized the study, arguing that its methodology was flawed.
HealthDay (3/19, Doheny) reports, "In a statement, the American College of Radiology (ACR) pointed to an analysis published in 2011 in the American Journal of Roentgenology finding that under the biennial model, about 6,500 more women annually in the United States would die of breast cancer." Comparing "early versus late-stage cancer is not the best way to judge the best interval for mammograms, according to the ACR statement." Instead, "it said, researchers should look at such factors as tumor size and other markers of detecting cancers early." Also covering the story are Aunt Minnie (3/19, Keen), MedPage Today (3/19, Fiore) and Medscape(3/19, Brown).
False-positive mammograms may have negative psychological effects. The Los Angeles Times (3/19, Brown, Times, 692K) reports, "Long after learning that a troubling reading on a screening mammogram was just a false alarm, women continued suffering negative psychological effects, researchers in Denmark have reported" in the Annals of Family Medicine. Researchers found that, "six months after hearing they did not have breast cancer, women with these false positives experienced changes in 'existential values' and 'inner calmness' as great as for women who had cancer."
On its website, ABC News (3/19, Moisse) reports that additionally, "women who had false positives were...more likely to report disturbances in sleep and sexuality, according to the study."
The NBC News (3/19, Fox) "Vitals" blog reports that the researchers wrote, "False-positive findings on screening mammography causes long-term psychosocial harm: Three years after a false-positive finding, women experience psycho-social consequences that range between those experienced by women with a normal mammogram and those with a diagnosis of breast cancer."