A day before, I wrote that we should not sell mammography as a screening modality in resource limited setting. Todayโs Annals of Internal Medicine carries recommendation of the U.S. Preventive Services Task Force (USPSTF) on screening for breast cancer in general population. Interestingly, USPSTF in 2002 had advocated for routine screening mammography at age 40; it now raises the bar, saying that women aged below 50 should not be screened for breast cancer.
According to task forceโs recent update, women aged 50 to 74 should undergo screening mammography every 2 years. There is no evidence that woman older than 75 would benefit from screening mammograms.
What about breast self-exams to pick up asymptomatic breast lumps? Although the examination costs nothing, it generates so many false-negatives and false-positives that the task force suggests that clinicians should not teach women how to perform breast self-exams.
The task force also says that newer techniques such as digital mammography or MRI may not have an edge over film mammography for detection of breast cancer.
Finally, some numbers in the article make an interesting reading. How many women we need to invite for screening mammography to extend one woman’s life? Here are numbers: we need to screen 1904 women aged 40 to 49; 1339 women aged 50 to 59 years and 377 women aged 60 to 69!
Include these numbers in your informed consent forms and let me know how many women, truly informed, choose to undergo mammography?
