Wednesday, January 13, 2010
ROCHESTER, Minn. — The U.S. Preventive Services Task Force (USPSTF) recommended in November 2009 that routine breast cancer screening begin at age 50, instead of 40 as previously advised. Discussions in the Senate and the House are leading toward an amendment in the pending health care bill that would provide insurance coverage for annual mammograms beginning at age 40.
Mayo Clinic has continued to recommend annual screening at 40, however, acknowledges that women need to be informed about its benefits, risks and limitations.
"Evidence continues to support the role of mammograms in reducing breast cancer mortality — they are the best screening tool available today," says Sandhya Pruthi, M.D., director of Mayo Clinic's Breast Clinic in Rochester, Minn.
"To address the concerns raised by the USPSTF regarding the false positives associated with screening mammograms, more emphasis needs to be placed on improving accuracy of mammograms, referrals to breast imaging centers where digital mammograms and core needle biopsies are available — and patients need to receive timely and coordinated care to alleviate anxiety.
Individualized risk assessment may be the next step in deciding who is at increased risk and when and how often screening should occur. Health care providers need risk assessment tools designed for individualized risk, not population risk."
Ongoing research at Mayo Clinic is studying ways to improve breast cancer risk stratification. Dr. Pruthi says further research is also critical to better understand tumor biology and to develop biomarkers or tests for early detection.
"We also need better ways to communicate risk and help patients understand how to weigh the risks versus benefits of screening mammograms," she says. "An amendment in the health care bill to provide coverage for annual mammography screening is important and would certainly maintain our ability to provide quality preventive care to women."
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