Gabriel Miller; Clifford Hudis, MD


June 26, 2014

In This Article

Cancer Prevention and Epidemiology

Breast Cancer Screening in Younger Women

Currently, the US Preventive Services Task Force (USPSTF) recommends breast cancer screening with mammography only for high-risk women under 50. Oral abstract 1502 found that, despite the current recommendation, 67% of rural insured women aged 40-49 had a screening mammogram within the past year; 71% of these women felt that they understood the current guidelines, which were introduced in 2009, though less than 1% said that mammograms for women under 50 were not routinely recommended. And 58% of them said they believed that annual mammograms are recommended for women younger than 50.

Dr. Hudis: "I don't think that this study of breast screening in young women suggests anything about the underuse or overuse of mammography. That question can only be answered by looking at ethnicity and outcomes. What this talked about was why women did what they did -- the relationship between what they did and their awareness of the guidelines. But even at this point the guidelines are controversial, as you know. I think we're approaching this question just slightly wrongly anyway. From my point of view the question is, does mammography save lives? Then the question is, what are the risks? Then the question is, what's the risk-to-benefit ratio? We make a guideline and we promote it. Maybe someday we can tailor it to individuals. We can't right now. I think studying around the edges about why people do what they do when they perceive confusion on the guidelines is interesting from a behavioral point of view, but it doesn't get at the real core question, which is, what should they be doing?"


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