Are Annual Mammograms Really Necessary for Women Over 40?
A new guidance statement by the American College of Physicians (ACP) suggests not all women older than 40 need annual mammograms because the tests might end up causing more harm than doing good.
For years, women older than 40 have been advised to get annual mammograms, a screening procedure that uses low-energy X-rays to catch breast cancer in its early stages.
The ACP said their new guidance doesn’t apply to women who have a history of breast cancer, or who have a genetic mutation that makes them susceptible to it.
As per their new recommendations, it is only women between ages 45 and 54 who should be screened annually. Those between 40 and 45 should not opt for mammograms because of past guidelines, but rather get them by choice, states the ACP. And those above 55 should worry about getting mammograms only once in two years.
These recommendations echo opinions expressed by Indian oncologists about a decade ago.
Dr Rajendra Badwe, from Mumbai’s Tata Memorial Center, who has spoken about overdiagnosis as one of the main problems with annual screening, told The Telegraph, “The new ACP guidelines are exactly what we had proposed 15 years ago.”
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As per the ACP, the results from annual and bi-annual mammograms show no significant difference in breast cancer death rate. With no preventive benefits, annual mammograms are problematic because they can be harmful to one’s health. Some of the side effects of annual mammograms include overdiagnosis, overtreatment, false positive results, radiation exposure (which could contribute to an increased lifetime exposure to radiation, itself a risk factor for malignant cancer), as well as worry and distress from tests and procedures.
Overdiagnosis or overtreatment means diagnosing or treating a benign form of cancer that will not leave the person sick or pose a risk to their health. It risks patients being exposed to side effects of cancer treatment and worrying about a cancer diagnosis when they needn’t.
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Another harm that emerged as a result of annual screenings for women in the 40-45 age group, and women 55+, was the chance of receiving at least one false-positive result. It means that the mammogram shows something abnormal, even though there’s no cancer in the breast. Due to this, it is observed that the overall rate of biopsies are higher for women of any age who undergo annual mammography, versus those who do it once in two years.
Lastly, annual mammography acts as a deterrent to future testing programs, due to the frequent associated pain, which could keep women from seeking diagnosis and treatment of actual cancer cases.