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Radiology Groups: Recommended Mammogram Guidelines Will Increase Breast Cancer Deaths

Cheryl Clark, for HealthLeaders Media, November 17, 2009

Angry radiology groups are blasting a government panel's recommendations that women ages 40 to 49 forgo annual screening mammograms and that women between age 50 and 74 should have screening mammograms only once every other year rather than annually.

The U.S. Preventive Services Task Force review of literature advises that women over age 74 should stop all breast cancer screening because the practice lacks evidence of clinical benefit, and found that breast self-examination "does not reduce breast cancer mortality." The task force also noted the increased risk of false positives and other kinds of harm that result from medical overtreatment of abnormal findings that would never have caused death.

But officials for the Access to Medical Imaging Coalition (AMIC) and the American College of Radiology immediately jumped on the task force guidelines, calling them "shocking" and an attempt to "ration care." They said that if incorporated into reimbursement policies by government insurers and payers, many avoidable breast cancer deaths will occur.

"Two decades of decline in breast cancer mortality could be reversed and countless American women may die needlessly from breast cancer each year," according to a statement from the ACR. "Mammography is not a perfect test, but it has unquestionably been shown to save lives—including in women aged 40-49," said Carol H. Lee, MD, ACR chair.

"They say it's not cost efficient. Well, we're not comfortable putting a price tag on a woman's life," added Shawn Farley, ACR spokesman. Besides, he said, the typical mammogram reimbursement from Medicare is only $89. "That's one of the reasons why this (recommendation) is so perplexing."

W. Phil Evans, MD, president of the Society of Breast Imaging, said, "These recommendations are inconsistent with current science and apparently have been developed in an attempt to reduce costs."

"To tell women they should not get regular mammograms starting at 40, when this approach has overwhelmingly been shown to save lives, is shocking," Evans said. "At least 40% of the lives saved by mammographic screening are of women aged 40-49."

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