New Mammogram Guidelines – But Do They Make Sense?

Earlier this month the American Cancer Society (ACS) released new guidelines for mammography screening for women as published by the American Medical Association. http://www.cancer.org/index The new guidelines delay the recommended age when most women (not those at higher risk) should start receiving mammograms to age 45. The previous guideline recommended women at normal risk for breast cancer to start getting screening mammograms at age 40.

Already the American College of Radiology http://www.acr.org/ and the Society of Breast Imaging http://www.sbi-online.org/ have released statements holding firm with their recommended age of 40. I suspect physicians and physician organizations will do the same. There seems to be no rationale to the ACS’s new recommendation, although the changed guideline is claimed to be based on research and guidelines issued in 2009 by the US Preventative Services Task Force (USPSTF) http://www.uspreventiveservicestaskforce.org/ . The latter guideline issued by USPSTF has received much criticism as well.

How does the new guideline by the ACS make any sense? ACS advertisements ask us to “join the fight against cancer” while seeking donations for cancer research. The ACS claims to be “the official sponsor of birthdays” while promoting to us (and rightfully so) the lives they have saved in accomplishing their goals. Yet now the ACS has decided to cast away women younger than 45 years of age who may benefit from an earlier mammogram, or who may have their lives saved by this non-evasive, relatively inexpensive test. What a shame.

I have pursued many medical negligence claims against physicians who have not recommended earlier mammography. In the field of medical malpractice litigation, these new guidelines will have a profound effect. Physicians that fail to discuss earlier mammograms with their patients will now rely on the ACS guideline in court proceedings. Physicians that fail to prescribe a mammogram to their patients before age 45 will be absolved from liability.

Yet, according to earlier published reports by the ACS, one in eight women in the United States will be diagnosed with Breast Cancer during their lifetime, regardless of age. According to the ACS, there will be over 200,000 new cases of invasive breast cancer each year. Breast Cancer is the second leading cause of death for women with cancer between the ages of 20-59. Moreover, while it is well know that women at risk for breast cancer due to a family history or otherwise have a higher chance of getting the disease before age 40, the ACS has not recommended any guideline for earlier screening for the at-risk women in this category.

The new ACS guidelines will not save any more lives. They may lessen the burden of taking mammograms on the medical professionals, and lower the costs for the medical insurance companies. However, the end result will be women under the age of 45 with undiagnosed breast cancer and more deaths caused by the disease.

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