Women should be told the pros and cons of mammograms, study says : Shots

The latest recommendations from the U.S. Preventive Services Task Force suggest that all women ages 40 to 74 should get mammograms every other year. Previous recommendations had said screening should start at age 50. “Instead of testing more, we should test smarter,” one doctor suggests.

Heather Charles/Tribune News Service via Getty Images

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Heather Charles/Tribune News Service via Getty Images

A new study highlights the need to educate women in their 40s, who have been caught in the middle of a decades-long debate over whether they should get screened for breast cancer with mammograms, about the risks as well as the benefits of screening.

A nationwide survey of U.S. women ages 39 to 49 found that after learning about the pros and cons of mammograms, the number of women who chose to wait until age 50 to get screened more than doubled. study Announced on Monday Annals of Internal Medicine found.

By the time they reach midlife, most women have absorbed the widespread message that mammography screening saves lives. cost Routine screening in your 40s can lead to false positive results, unnecessary biopsies, anxiety and debilitating treatment for tumors that can be left untreated without harm.

“In an ideal world, all women would have access to this information and their doctors would be able to answer any further questions and develop an appropriate testing plan that takes into account their preferences, values ​​and risk level,” the social psychologist said. Laura Scherer He is the lead author of the study and a research associate professor at the University of Colorado School of Medicine.

Of the 495 women surveyed, only 8% initially said they would wait until age 50 to get a mammogram. After researchers informed the women of the benefits and drawbacks of mammograms, 18% said they would wait until age 50.

“We're not being honest.”

The study found that knowing about the drawbacks of mammograms doesn't make women any less willing to get screened eventually.

The benefits and harms of mammograms came as a surprise to nearly half of study participants, and more than a quarter said what they learned from research about overdiagnosis differed from what their doctors had told them.

“We're not being honest with people,” said the breast cancer surgeon Dr. Laura EssermanShe is director of the University of California, San Francisco's Breast Cancer Care Center and was not involved in the study.

“We've had 30, 40 years of public health messaging campaigns that say, 'Get your mammogram and everything's OK,' so I think most people are completely unaware of the risks associated with screening,” she told NPR in an interview.

Esserman sees women who are diagnosed with slow-growing tumors that she believes are unlikely to harm them, and what's more, she says, mammograms can give women a false sense of security. Olivia Munn.

44-year-old actress Mammography showed no abnormalities Then, just before her doctors were about to calculate her lifetime breast cancer risk score, she received a negative cancer genetic test, raising her alarm and leading her to undergo treatment for an aggressive, aggressive form of breast cancer in both breasts.

Towards an individualised plan for screening

Esserman advocates for a personalized approach to breast cancer screening like the one that led to Mann's diagnosis. In 2016, she WISDOM ResearchThe idea is to tailor testing to a woman's risk and, in her words, “test smarter, not test more.”

National Cancer Institute Quote This year, more than 300,000 women will be diagnosed with breast cancer in the United States, and 42,250 will die from it. Incidence rates are rising about 1% per year, while death rates are falling by just over 1% per year.

Influential for the past 28 years U.S. Preventive Services Task Force Recommendations about when women should start having mammograms vary.

From 1996 to 2002, an independent panel of volunteer medical experts who advise doctors, insurers, and policymakers argued that women should start screening at age 50. In 2002, the task force said women in their 40s should be screened every one to two years. In 2009, it said women in their 40s should decide whether to have mammograms based on their health history and personal preference.

The new survey would be conducted in 2022, but the task force guidelines called for an individual decision to be made for women in their 40s.

New Guidelines

In 2024, panel She returned to her position that all women between the ages of 40 and 74 should get mammograms every other year. The impetus for earlier screening was fueled by models showing rising rates of breast cancer among younger women and the number of lives that screening could save, especially among black women.

Ann editorial An accompanying report for this new study highlights the need for education about mammograms and the value of shared decision-making between doctors and patients.

“The harms of overdiagnosis – defined as the diagnosis of asymptomatic cancer that will not harm the patient in the future – must be communicated to make informed decisions,” says the editorial, written by Dr. Victoria Mintsopoulos and Dr. Michelle B. Nadler of the University of Toronto in Ontario.