False Alarm Mammograms May Still Signal Higher Breast Cancer Risk
How to Untangle Conflicting Mammogram Advice
You Heard It Right: American Cancer Society Now Recommends Fewer Mammograms
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More Mammograms May Not Reduce Breast Cancer Deaths, Study Finds
Not All Women with Dense Breasts Are at High Risk of Cancer
Mammogram in Your 40s Still a Personal Decision, Task Force Says
The Hidden Cost of Mammograms: More Testing and Overtreatment
See What Happens After You Get A Mammogram
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FM","link":"/"}},"stateofhealth_117249":{"type":"posts","id":"stateofhealth_117249","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"117249","score":null,"sort":[1449079677000]},"guestAuthors":[],"slug":"false-alarm-mammograms-may-still-signal-higher-breast-cancer-risk","title":"False Alarm Mammograms May Still Signal Higher Breast Cancer Risk","publishDate":1449079677,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Women who have an abnormal mammogram should stay vigilant for cancer for the next decade, even when follow-up tests fail to detect cancer, a study released Wednesday finds.\u003c/p>\n\u003cp>That's because there's a \"modest\" risk that cancer will develop during the next decade, says lead author \u003ca href=\"https://www.med.unc.edu/bric/people/faculty-pages/louise-henderson\" target=\"_blank\">Louise M. Henderson\u003c/a> of the University of North Carolina School of Medicine in Chapel Hill.\u003c/p>\n\u003cp>The absolute increase in risk amounts to about one additional cancer in every 100 women who have a false positive mammogram over a 10-year period, she says.\u003c/p>\n\u003cp>But when put another way, the numbers may appear alarming. The study divided women into two groups — those who got additional imaging and those who also got biopsies.\u003c/p>\n\u003cp>Women with an abnormal screening mammogram had a 39 percent higher risk of cancer if they got additional imaging that turned out to be negative, too. That's compared with women who were truly negative and never developed breast cancer.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For women who got biopsies that turned out negative, the chance of cancer was increased by 76 percent over the next 10 years.\u003c/p>\n\u003cp>\"We don't want women to read this and feel worried,\" Henderson says. Instead, the findings should be considered one more \"useful tool\" when weighing all the other factors that might be raising a particular woman's risk, such as age, race, breast density and family history of breast cancer.\u003c/p>\n\u003cp>Henderson says the study wasn't designed to figure out why a falsely positive mammogram is associated with an increased cancer risk.\u003c/p>\n\u003cp>It's possible, she says, that the increased risk \"could be the fact that the radiologist sees an abnormal pattern that's not cancerous, but it's a radio-graphic marker,\" and it could be that this is a precursor to some subsequent cancer diagnosis.\u003c/p>\n\u003cp>The study, done at several leading universities, looked back at more than 2.2 million screening mammograms considered to be false alarms between 1994 and 2009. It was \u003ca href=\"http://cebp.aacrjournals.org/content/early/2015/11/09/1055-9965.EPI-15-0623.abstract\" target=\"_blank\">published Wednesday\u003c/a> in \u003cem>Cancer Epidemiology, Biomarkers & Prevention. \u003c/em>The mammograms were done in 1.3 million women, ages 40 to 74.\u003c/p>\n\u003cp>Earlier studies have had conflicting results. But the size of this study makes researchers more confident that whatever is going on is a true phenomenon and not chance, says \u003ca href=\"http://pressroom.cancer.org/index.php?s=20&item=167\" target=\"_blank\">Dr. Richard Wender\u003c/a>, chief cancer control officer of the American Cancer Society.\u003c/p>\n\u003cp>\"If you've had a false positive, that is a risk factor,\" he says, \"so it's very important that a woman stay up to date with regular mammography.\"\u003c/p>\n\u003cp>As it is now, Wender says, at least one-third of women who should be getting routinely screened for breast cancer are falling behind schedule.\u003c/p>\n\u003cp>The cancer society \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/20/449920789/cancer-group-now-says-most-mammograms-can-wait-till-45\" target=\"_blank\">created controversy\u003c/a> in October, when it changed its guidelines to recommend that regular screening start at age 45. Other groups recommend starting earlier, at age 40, and some say it's OK to wait until age 50.\u003c/p>\n\u003cp>Studies have shown that the chance of getting an abnormal screening mammogram that is falsely positive is about 50 percent over the course of 10 years. That often leads to further testing, including more mammograms, possible ultrasound exams, MRIs and even biopsies.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=False+Alarm+Mammograms+May+Still+Signal+Higher+Breast+Cancer+Risk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Women who have a 'false positive' mammogram have a somewhat higher risk of developing breast cancer over the next 10 years.","status":"publish","parent":0,"modified":1449097352,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":540},"headData":{"title":"False Alarm Mammograms May Still Signal Higher Breast Cancer Risk | KQED","description":"Women who have a 'false positive' mammogram have a somewhat higher risk of developing breast cancer over the next 10 years.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"117249 http://ww2.kqed.org/stateofhealth/?p=117249","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/12/02/false-alarm-mammograms-may-still-signal-higher-breast-cancer-risk/","disqusTitle":"False Alarm Mammograms May Still Signal Higher Breast Cancer Risk","source":"NPR","sourceUrl":"http://www.npr.org/sections/health-shots/2015/12/02/458057324/false-alarm-mammograms-may-still-signal-higher-breast-cancer-risk","nprImageCredit":"Lester Lefkowitz","nprByline":"Patti Neighmond and Joe Neel","nprImageAgency":"Getty Images","nprStoryId":"458057324","nprApiLink":"http://api.npr.org/query?id=458057324&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/12/02/458057324/false-alarm-mammograms-may-still-signal-higher-breast-cancer-risk?ft=nprml&f=458057324","nprRetrievedStory":"1","nprPubDate":"Wed, 02 Dec 2015 11:45:00 -0500","nprStoryDate":"Wed, 02 Dec 2015 00:09:00 -0500","nprLastModifiedDate":"Wed, 02 Dec 2015 11:45:27 -0500","nprAudio":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/12/20151202_me_false_alarm_mammograms_may_still_signal_higher_breast_cancer_risk.mp3?orgId=1&topicId=1128&d=221&p=3&story=458057324&t=progseg&e=458125565&seg=19&ft=nprml&f=458057324","nprAudioM3u":"http://api.npr.org/m3u/1458127788-3be581.m3u?orgId=1&topicId=1128&d=221&p=3&story=458057324&t=progseg&e=458125565&seg=19&ft=nprml&f=458057324","path":"/stateofhealth/117249/false-alarm-mammograms-may-still-signal-higher-breast-cancer-risk","audioUrl":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/12/20151202_me_false_alarm_mammograms_may_still_signal_higher_breast_cancer_risk.mp3?orgId=1&topicId=1128&d=221&p=3&story=458057324&t=progseg&e=458125565&seg=19&ft=nprml&f=458057324","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Women who have an abnormal mammogram should stay vigilant for cancer for the next decade, even when follow-up tests fail to detect cancer, a study released Wednesday finds.\u003c/p>\n\u003cp>That's because there's a \"modest\" risk that cancer will develop during the next decade, says lead author \u003ca href=\"https://www.med.unc.edu/bric/people/faculty-pages/louise-henderson\" target=\"_blank\">Louise M. Henderson\u003c/a> of the University of North Carolina School of Medicine in Chapel Hill.\u003c/p>\n\u003cp>The absolute increase in risk amounts to about one additional cancer in every 100 women who have a false positive mammogram over a 10-year period, she says.\u003c/p>\n\u003cp>But when put another way, the numbers may appear alarming. The study divided women into two groups — those who got additional imaging and those who also got biopsies.\u003c/p>\n\u003cp>Women with an abnormal screening mammogram had a 39 percent higher risk of cancer if they got additional imaging that turned out to be negative, too. That's compared with women who were truly negative and never developed breast cancer.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For women who got biopsies that turned out negative, the chance of cancer was increased by 76 percent over the next 10 years.\u003c/p>\n\u003cp>\"We don't want women to read this and feel worried,\" Henderson says. Instead, the findings should be considered one more \"useful tool\" when weighing all the other factors that might be raising a particular woman's risk, such as age, race, breast density and family history of breast cancer.\u003c/p>\n\u003cp>Henderson says the study wasn't designed to figure out why a falsely positive mammogram is associated with an increased cancer risk.\u003c/p>\n\u003cp>It's possible, she says, that the increased risk \"could be the fact that the radiologist sees an abnormal pattern that's not cancerous, but it's a radio-graphic marker,\" and it could be that this is a precursor to some subsequent cancer diagnosis.\u003c/p>\n\u003cp>The study, done at several leading universities, looked back at more than 2.2 million screening mammograms considered to be false alarms between 1994 and 2009. It was \u003ca href=\"http://cebp.aacrjournals.org/content/early/2015/11/09/1055-9965.EPI-15-0623.abstract\" target=\"_blank\">published Wednesday\u003c/a> in \u003cem>Cancer Epidemiology, Biomarkers & Prevention. \u003c/em>The mammograms were done in 1.3 million women, ages 40 to 74.\u003c/p>\n\u003cp>Earlier studies have had conflicting results. But the size of this study makes researchers more confident that whatever is going on is a true phenomenon and not chance, says \u003ca href=\"http://pressroom.cancer.org/index.php?s=20&item=167\" target=\"_blank\">Dr. Richard Wender\u003c/a>, chief cancer control officer of the American Cancer Society.\u003c/p>\n\u003cp>\"If you've had a false positive, that is a risk factor,\" he says, \"so it's very important that a woman stay up to date with regular mammography.\"\u003c/p>\n\u003cp>As it is now, Wender says, at least one-third of women who should be getting routinely screened for breast cancer are falling behind schedule.\u003c/p>\n\u003cp>The cancer society \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/20/449920789/cancer-group-now-says-most-mammograms-can-wait-till-45\" target=\"_blank\">created controversy\u003c/a> in October, when it changed its guidelines to recommend that regular screening start at age 45. Other groups recommend starting earlier, at age 40, and some say it's OK to wait until age 50.\u003c/p>\n\u003cp>Studies have shown that the chance of getting an abnormal screening mammogram that is falsely positive is about 50 percent over the course of 10 years. That often leads to further testing, including more mammograms, possible ultrasound exams, MRIs and even biopsies.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=False+Alarm+Mammograms+May+Still+Signal+Higher+Breast+Cancer+Risk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/117249/false-alarm-mammograms-may-still-signal-higher-breast-cancer-risk","authors":["byline_stateofhealth_117249"],"categories":["stateofhealth_13"],"tags":["stateofhealth_176","stateofhealth_461"],"featImg":"stateofhealth_117250","label":"source_stateofhealth_117249"},"stateofhealth_95854":{"type":"posts","id":"stateofhealth_95854","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"95854","score":null,"sort":[1445459442000]},"guestAuthors":[],"slug":"how-to-untangle-conflicting-mammogram-advice","title":"How to Untangle Conflicting Mammogram Advice","publishDate":1445459442,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>Stephanie Nichols is a stay-at-home mom in Boston. She's 44 now and says she first thought about getting a mammogram when she turned 40.\u003c/p>\n\u003cp>\"I had heard from a number of friends all around the same age that they're all getting mammograms,\" she says. So it came as no surprise when her doctor brought up the topic at her next routine exam.\u003c/p>\n\u003cp>But what was surprising, she says, was that, after discussing family history and personal health, her doctor determined that because Nichols was not at high risk for getting breast cancer, it was probably too soon to get that first scan. Together, they decided to postpone her first mammogram screening test until she was 45.\u003c/p>\n\u003cp>Nichols says she felt comfortable with that decision, \"knowing that my risk for breast cancer was low compared to the risk of having to have more invasive procedures such as biopsies or lumpectomies.\"\u003c/p>\n\u003cp>She's right about the statistics. Researchers say that, across a 10-year period of getting annual mammograms, women overall have a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3209800/\" target=\"_blank\">50-50 chance\u003c/a> of being called back at least once for further testing that turns up nothing cancerous.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And that's one reason why the American Cancer Society \u003ca href=\"http://www.cancer.org/cancer/news/specialcoverage/american-cancer-society-breast-cancer-screening-guidelines\" target=\"_blank\">changed\u003c/a> its advice Tuesday. It now recommends that instead of getting that first screening mammogram at age 40, women who don't have an increased risk for breast cancer can start the screening later — at age 45.\u003c/p>\n\u003cp>[contextly_sidebar id=\"jZFyNZkROyO3IS2b9QQ0aXRy5Ns0o0a2\"]But even that advice starts the screening too soon, according to the U.S. Preventive Services Task Force, which still advises most women of average risk to \u003ca href=\"http://screeningforbreastcancer.org/\" target=\"_blank\">wait till they're 50\u003c/a>. Meanwhile, the American College of Obstetricians and Gynecologists still suggests most women get their first screening \u003ca href=\"http://www.acog.org/Patients/FAQs/Mammography-and-Other-Screening-Tests-for-Breast-Problems\" target=\"_blank\">at 40\u003c/a>. So, which advice is best for you?\u003c/p>\n\u003cp>Dr. Lydia Pace is an internist and primary care doctor at Brigham and Women's Hospital in Boston and describes a \"really wide range in the way women approach this question.\" She says some women come in already knowing they want to start screening at age 40; some ask about screening even before age 40; and some are seeking a more nuanced conversation with the doctor about the particulars of their situation.\u003c/p>\n\u003cp>And Dr. Pace says that discussion with your doctor is absolutely the best approach. If you're at higher risk than average — if your mother or sisters or aunts had breast cancer, for example — it might be reasonable to start screening at 40.\u003c/p>\n\u003cp>Other women who are very worried about getting breast cancer may reasonably start at 40, too, Pace says. This might include some women, for example, who have had strong personal experiences with family or friends who got the illness.\u003c/p>\n\u003cp>\"That may be a much more powerful influence for them than any conversation we can have,\" says Pace.\u003c/p>\n\u003cp>And that's OK, she says. These women could reasonably decide that, for them, the increased peace of mind they'll get with a clear mammogram outweighs the increased risk that they'll also have to undergo further expensive scans, unnecessary biopsies and other testing.\u003c/p>\n\u003cp>[contextly_sidebar id=\"TaYE37DxnIHvG7womU8kUBj46TS6yI11\"]If you wish the evidence about when and how often to screen for breast cancer were more clear-cut, or that the leading groups of doctors offering advice could get on the same page, you're not alone. Lots of doctors are frustrated too.\u003c/p>\n\u003cp>Dr. Laura Esserman, who directs the UC San Francisco Breast Cancer Center, notes that every year, roughly 40,000 women die of breast cancer. What's most important now, she says, is putting energy into finding reliable solutions instead of \"arguing about it.\"\u003c/p>\n\u003cp>Part of the problem, she says, is that the data everyone's basing their argument and recommendations on is 30 to 40 years old. She says the studies \"were done before we had modern treatments for breast cancer, before we knew about the different kinds of breast cancer, before we understood a lot about breast cancer risk.\"\u003c/p>\n\u003cp>\"And so it's high time we do a modern trial where we put some new ideas to the test,\" Esserman says.\u003c/p>\n\u003cp>She recently received a grant to see whether a personalized approach, like the one Stephanie Nichols worked out with her doctor, is as safe and effective at catching aggressive cancers as yearly mammograms starting at age 40.\u003c/p>\n\u003cp>In the meantime, when should women \u003cem>stop\u003c/em> getting screening mammograms? That too, for now, depends on whom you ask.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+Is+Mammogram+Advice+Still+Such+A+Tangle%3F+Ask+Your+Doctor&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Leading groups don't agree about when and how often women should get a screening mammogram. Your history and preferences can guide you.","status":"publish","parent":0,"modified":1445464355,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":759},"headData":{"title":"How to Untangle Conflicting Mammogram Advice | KQED","description":"Leading groups don't agree about when and how often women should get a screening mammogram. Your history and preferences can guide you.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"95854 http://ww2.kqed.org/stateofhealth/?p=95854","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/21/how-to-untangle-conflicting-mammogram-advice/","disqusTitle":"How to Untangle Conflicting Mammogram Advice","source":"NPR","sourceUrl":"http://www.npr.org/sections/health-shots/2015/10/21/450333627/why-is-mammogram-advice-still-such-a-tangle-ask-your-doctor","nprByline":"Patti Neighmond","nprStoryId":"450333627","nprApiLink":"http://api.npr.org/query?id=450333627&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/10/21/450333627/why-is-mammogram-advice-still-such-a-tangle-ask-your-doctor?ft=nprml&f=450333627","nprRetrievedStory":"1","nprPubDate":"Wed, 21 Oct 2015 10:42:00 -0400","nprStoryDate":"Wed, 21 Oct 2015 05:12:00 -0400","nprLastModifiedDate":"Wed, 21 Oct 2015 10:42:33 -0400","nprAudio":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/10/20151021_me_why_is_mammogram_advice_still_such_a_tangle_ask_your_doctor.mp3?orgId=1&topicId=1128&d=229&p=3&story=450333627&t=progseg&e=450461078&seg=20&ft=nprml&f=450333627","nprAudioM3u":"http://api.npr.org/m3u/1450464773-f0bc0b.m3u?orgId=1&topicId=1128&d=229&p=3&story=450333627&t=progseg&e=450461078&seg=20&ft=nprml&f=450333627","path":"/stateofhealth/95854/how-to-untangle-conflicting-mammogram-advice","audioUrl":"http://pd.npr.org/anon.npr-mp3/npr/me/2015/10/20151021_me_why_is_mammogram_advice_still_such_a_tangle_ask_your_doctor.mp3?orgId=1&topicId=1128&d=229&p=3&story=450333627&t=progseg&e=450461078&seg=20&ft=nprml&f=450333627","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Stephanie Nichols is a stay-at-home mom in Boston. She's 44 now and says she first thought about getting a mammogram when she turned 40.\u003c/p>\n\u003cp>\"I had heard from a number of friends all around the same age that they're all getting mammograms,\" she says. So it came as no surprise when her doctor brought up the topic at her next routine exam.\u003c/p>\n\u003cp>But what was surprising, she says, was that, after discussing family history and personal health, her doctor determined that because Nichols was not at high risk for getting breast cancer, it was probably too soon to get that first scan. Together, they decided to postpone her first mammogram screening test until she was 45.\u003c/p>\n\u003cp>Nichols says she felt comfortable with that decision, \"knowing that my risk for breast cancer was low compared to the risk of having to have more invasive procedures such as biopsies or lumpectomies.\"\u003c/p>\n\u003cp>She's right about the statistics. Researchers say that, across a 10-year period of getting annual mammograms, women overall have a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3209800/\" target=\"_blank\">50-50 chance\u003c/a> of being called back at least once for further testing that turns up nothing cancerous.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And that's one reason why the American Cancer Society \u003ca href=\"http://www.cancer.org/cancer/news/specialcoverage/american-cancer-society-breast-cancer-screening-guidelines\" target=\"_blank\">changed\u003c/a> its advice Tuesday. It now recommends that instead of getting that first screening mammogram at age 40, women who don't have an increased risk for breast cancer can start the screening later — at age 45.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>But even that advice starts the screening too soon, according to the U.S. Preventive Services Task Force, which still advises most women of average risk to \u003ca href=\"http://screeningforbreastcancer.org/\" target=\"_blank\">wait till they're 50\u003c/a>. Meanwhile, the American College of Obstetricians and Gynecologists still suggests most women get their first screening \u003ca href=\"http://www.acog.org/Patients/FAQs/Mammography-and-Other-Screening-Tests-for-Breast-Problems\" target=\"_blank\">at 40\u003c/a>. So, which advice is best for you?\u003c/p>\n\u003cp>Dr. Lydia Pace is an internist and primary care doctor at Brigham and Women's Hospital in Boston and describes a \"really wide range in the way women approach this question.\" She says some women come in already knowing they want to start screening at age 40; some ask about screening even before age 40; and some are seeking a more nuanced conversation with the doctor about the particulars of their situation.\u003c/p>\n\u003cp>And Dr. Pace says that discussion with your doctor is absolutely the best approach. If you're at higher risk than average — if your mother or sisters or aunts had breast cancer, for example — it might be reasonable to start screening at 40.\u003c/p>\n\u003cp>Other women who are very worried about getting breast cancer may reasonably start at 40, too, Pace says. This might include some women, for example, who have had strong personal experiences with family or friends who got the illness.\u003c/p>\n\u003cp>\"That may be a much more powerful influence for them than any conversation we can have,\" says Pace.\u003c/p>\n\u003cp>And that's OK, she says. These women could reasonably decide that, for them, the increased peace of mind they'll get with a clear mammogram outweighs the increased risk that they'll also have to undergo further expensive scans, unnecessary biopsies and other testing.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>If you wish the evidence about when and how often to screen for breast cancer were more clear-cut, or that the leading groups of doctors offering advice could get on the same page, you're not alone. Lots of doctors are frustrated too.\u003c/p>\n\u003cp>Dr. Laura Esserman, who directs the UC San Francisco Breast Cancer Center, notes that every year, roughly 40,000 women die of breast cancer. What's most important now, she says, is putting energy into finding reliable solutions instead of \"arguing about it.\"\u003c/p>\n\u003cp>Part of the problem, she says, is that the data everyone's basing their argument and recommendations on is 30 to 40 years old. She says the studies \"were done before we had modern treatments for breast cancer, before we knew about the different kinds of breast cancer, before we understood a lot about breast cancer risk.\"\u003c/p>\n\u003cp>\"And so it's high time we do a modern trial where we put some new ideas to the test,\" Esserman says.\u003c/p>\n\u003cp>She recently received a grant to see whether a personalized approach, like the one Stephanie Nichols worked out with her doctor, is as safe and effective at catching aggressive cancers as yearly mammograms starting at age 40.\u003c/p>\n\u003cp>In the meantime, when should women \u003cem>stop\u003c/em> getting screening mammograms? That too, for now, depends on whom you ask.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+Is+Mammogram+Advice+Still+Such+A+Tangle%3F+Ask+Your+Doctor&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/95854/how-to-untangle-conflicting-mammogram-advice","authors":["byline_stateofhealth_95854"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_176","stateofhealth_397"],"featImg":"stateofhealth_95855","label":"source_stateofhealth_95854"},"stateofhealth_95297":{"type":"posts","id":"stateofhealth_95297","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"95297","score":null,"sort":[1445364406000]},"guestAuthors":[],"slug":"the-american-cancer-society-now-recommends-fewer-mammograms","title":"You Heard It Right: American Cancer Society Now Recommends Fewer Mammograms","publishDate":1445364406,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>In 2009, an influential panel \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening?ds=1&s=breast%20cancer\" target=\"_blank\">updated its guidelines\u003c/a> about mammograms -- when women should start getting them and how frequently -- and ignited a firestorm. More on their recommendations below, but in short, the U.S. Preventive Services Task Force said that average-risk women in their 40s could skip screening and start every-other-year mammograms at age 50.\u003c/p>\n\u003cp>Since then, the august American Cancer Society stayed its course and kept recommending that women get annual mammograms starting at age 40.\u003c/p>\n\u003cp>Until today. Now, in updated guidelines, the American Cancer Society says that women can wait to commence mammograms until age 45 and have them every year until age 54. Starting at 55, women should have them every other year.\u003c/p>\n\u003cp>The recommendation is for women at average risk, not for women with a family history or other factors that would put them at higher risk. The new \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2463262\" target=\"_blank\">guidelines were published \u003c/a>in the journal JAMA.\u003c/p>\n\u003cp>These are \"big changes\" for the American Cancer Society, writes Liz Szabo at \u003ca href=\"http://www.usatoday.com/story/news/2015/10/20/american-cancer-society-say-women-should-start-mammograms-45/74232470/?csp=breakingnews\" target=\"_blank\">USA Today\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>As recently as 1992, the American Cancer Society recommended women get a \"baseline\" mammogram at age 35 to 39, so that doctors would have an image to which to compare their later screening results.\u003c/p>\n\u003cp>The new guidelines reflect the growing recognition that mammograms can do harm, as well as good, said Richard Wender, chief cancer control officer at the American Cancer Society.\u003c/p>\n\u003cp>\"The biggest evolution has been not in the American Cancer Society, but in the science of cancer screening and the evolution of health care in general,\" Wender said.\u003c/p>\u003c/blockquote>\n\u003cp>In another significant change, the cancer society also said doctors should no longer perform routine clinical breast exams. There's no evidence that these exams save lives.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While the cancer society's guidelines move closer to that of the task force that ignited a debate, the two organizations recommendations still differ:\u003c/p>\n\u003cul>\n\u003cli>American Cancer Society -- ages 45-54 annual mammograms; age 55 and for as long as a woman is healthy -- and has a life expectancy of at least 10 years -- every other year\u003c/li>\n\u003cli>U.S. Preventive Services Task Force -- mammograms every other year starting at age 50, until age 74. More research is needed, the group says, on potential benefits in women 75 and older\u003c/li>\n\u003c/ul>\n\u003cp>As the cancer society has moved toward less frequent screening, \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/20/449920789/cancer-group-now-says-most-mammograms-can-wait-till-45\" target=\"_blank\">Rob Stein at NPR reports\u003c/a> that some experts hope that it will reduce confusion in women:\u003c/p>\n\u003cblockquote>\u003cp>\"There really is not a single answer to the question: Should I have a mammogram?\" says \u003ca href=\"http://www.hcp.med.harvard.edu/faculty/core/nancy-keating-md-mph\" target=\"_blank\">Nancy Keating\u003c/a>, a professor of health care policy at Harvard Medical School and a physician at the Brigham & Women's Hospital.\u003c/p>\n\u003cp>\"It really involves looking at each patient individually,\" she says, \"thinking about their risk of developing breast cancer and thinking about the harms.\" She co-authored an \u003ca href=\"http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2015.13086\" target=\"_blank\">editorial\u003c/a> published with the new guidelines.\u003c/p>\n\u003cp>But it doesn't look like the new guidelines will end the debate. The American College of Radiology and the Society of Breast Imaging, for example, still recommend annual mammography beginning at age 40. Later, less frequent screening could be risky, they say.\u003c/p>\n\u003cp>\"I am personally concerned as a woman and as a person heavily involved in breast cancer screening [that] there will be lives that we could save that will be lost,\" says \u003ca href=\"http://www.sw.org/Dr-Debra-L-Monticciolo\" target=\"_blank\">Dr. Debra Monticciolo\u003c/a>, a professor of radiology at Texas A&M Health Science Center College of Medicine. She chairs the radiology college's commission on breast imaging.\u003c/p>\u003c/blockquote>\n\u003cp>[contextly_sidebar id=\"rZvfCYBX7jHggiQhhG0bWHsaVear3MwO\"]While most women grasp the benefit of cancer screening, the harms of mammograms are likely less well-known to the average patient. Denise Grady at the New York Times outlined the risk of \"false positives,\" a finding on a mammogram which is suspicious, but only through additional testing, often including biopsies, can the finding be determined not to be cancer. From\u003ca href=\"http://www.nytimes.com/2015/10/21/health/breast-cancer-screening-guidelines.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0\" target=\"_blank\"> the Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>A 2011 study cited in the article explaining the new [cancer society] guidelines found that 61 percent of women who had yearly mammograms starting at age 40 had at least one false positive by the time they were 50. Being tested every other year instead of every year can cut the false positive rate significantly, ... to about 42 percent from 61 percent.\u003c/p>\n\u003cp class=\"story-body-text story-content\">Some women consider false positives a small price to pay for the chance of identifying a cancer early. Others find being called back for more tests too nerve-racking.\u003c/p>\n\u003cp class=\"story-body-text story-content\">Another potential risk of mammography is overdiagnosis, meaning that some of the tiny cancers it finds might never progress or threaten the patient’s life. But because there is now no way to be sure which will turn dangerous, they are treated anyway.\u003c/p>\n\u003c/blockquote>\n\u003cp>The treatment can include surgery, radiation and chemotherapy.\u003c/p>\n\u003cp>\u003ca href=\"http://bcaction.org/2015/10/20/american-cancer-society-screening-guidelines-for-breast-cancer-baby-step-toward-evidence-based-recommendations/\" target=\"_blank\">In a statement,\u003c/a> the San Francisco-based Breast Cancer Action, which has long advocated for changes in screening guidelines, said it welcomed the \"long overdue step\" by the cancer society.\u003c/p>\n\u003cp>“After years of relentlessly promoting annual mammography for women age 40 and older and overstating the benefits of early detection, the ACS is finally starting to follow the evidence on the limitations of routine breast cancer screening for women at average risk,” said Karuna Jaggar, executive director of Breast Cancer Action.\u003c/p>\n\u003cp>\"The reality is tens of thousands of women each year would have been spared the harms of overtreatment if the ACS and other large cancer organizations had followed the evidence sooner,\" Jaggar said.\u003c/p>\n\u003cp>The cancer society says women ages 40-44 who wish to have mammograms should be informed of the test's risks and benefits.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force is in the process of \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/breast-cancer-screening1\" target=\"_blank\">updating its guidelines\u003c/a>, especially for women in their 40s, and now says: \"The decision to start screening mammography in women prior to age 50 years should be an individual one.\"\u003c/p>\n\n","blocks":[],"excerpt":"For starters, instead of starting at age 40, the society now recommends that women should start at age 45.","status":"publish","parent":0,"modified":1445396414,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":981},"headData":{"title":"You Heard It Right: American Cancer Society Now Recommends Fewer Mammograms | KQED","description":"For starters, instead of starting at age 40, the society now recommends that women should start at age 45.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"95297 http://ww2.kqed.org/stateofhealth/?p=95297","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/20/the-american-cancer-society-now-recommends-fewer-mammograms/","disqusTitle":"You Heard It Right: American Cancer Society Now Recommends Fewer Mammograms","path":"/stateofhealth/95297/the-american-cancer-society-now-recommends-fewer-mammograms","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In 2009, an influential panel \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening?ds=1&s=breast%20cancer\" target=\"_blank\">updated its guidelines\u003c/a> about mammograms -- when women should start getting them and how frequently -- and ignited a firestorm. More on their recommendations below, but in short, the U.S. Preventive Services Task Force said that average-risk women in their 40s could skip screening and start every-other-year mammograms at age 50.\u003c/p>\n\u003cp>Since then, the august American Cancer Society stayed its course and kept recommending that women get annual mammograms starting at age 40.\u003c/p>\n\u003cp>Until today. Now, in updated guidelines, the American Cancer Society says that women can wait to commence mammograms until age 45 and have them every year until age 54. Starting at 55, women should have them every other year.\u003c/p>\n\u003cp>The recommendation is for women at average risk, not for women with a family history or other factors that would put them at higher risk. The new \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2463262\" target=\"_blank\">guidelines were published \u003c/a>in the journal JAMA.\u003c/p>\n\u003cp>These are \"big changes\" for the American Cancer Society, writes Liz Szabo at \u003ca href=\"http://www.usatoday.com/story/news/2015/10/20/american-cancer-society-say-women-should-start-mammograms-45/74232470/?csp=breakingnews\" target=\"_blank\">USA Today\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>As recently as 1992, the American Cancer Society recommended women get a \"baseline\" mammogram at age 35 to 39, so that doctors would have an image to which to compare their later screening results.\u003c/p>\n\u003cp>The new guidelines reflect the growing recognition that mammograms can do harm, as well as good, said Richard Wender, chief cancer control officer at the American Cancer Society.\u003c/p>\n\u003cp>\"The biggest evolution has been not in the American Cancer Society, but in the science of cancer screening and the evolution of health care in general,\" Wender said.\u003c/p>\u003c/blockquote>\n\u003cp>In another significant change, the cancer society also said doctors should no longer perform routine clinical breast exams. There's no evidence that these exams save lives.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While the cancer society's guidelines move closer to that of the task force that ignited a debate, the two organizations recommendations still differ:\u003c/p>\n\u003cul>\n\u003cli>American Cancer Society -- ages 45-54 annual mammograms; age 55 and for as long as a woman is healthy -- and has a life expectancy of at least 10 years -- every other year\u003c/li>\n\u003cli>U.S. Preventive Services Task Force -- mammograms every other year starting at age 50, until age 74. More research is needed, the group says, on potential benefits in women 75 and older\u003c/li>\n\u003c/ul>\n\u003cp>As the cancer society has moved toward less frequent screening, \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/20/449920789/cancer-group-now-says-most-mammograms-can-wait-till-45\" target=\"_blank\">Rob Stein at NPR reports\u003c/a> that some experts hope that it will reduce confusion in women:\u003c/p>\n\u003cblockquote>\u003cp>\"There really is not a single answer to the question: Should I have a mammogram?\" says \u003ca href=\"http://www.hcp.med.harvard.edu/faculty/core/nancy-keating-md-mph\" target=\"_blank\">Nancy Keating\u003c/a>, a professor of health care policy at Harvard Medical School and a physician at the Brigham & Women's Hospital.\u003c/p>\n\u003cp>\"It really involves looking at each patient individually,\" she says, \"thinking about their risk of developing breast cancer and thinking about the harms.\" She co-authored an \u003ca href=\"http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2015.13086\" target=\"_blank\">editorial\u003c/a> published with the new guidelines.\u003c/p>\n\u003cp>But it doesn't look like the new guidelines will end the debate. The American College of Radiology and the Society of Breast Imaging, for example, still recommend annual mammography beginning at age 40. Later, less frequent screening could be risky, they say.\u003c/p>\n\u003cp>\"I am personally concerned as a woman and as a person heavily involved in breast cancer screening [that] there will be lives that we could save that will be lost,\" says \u003ca href=\"http://www.sw.org/Dr-Debra-L-Monticciolo\" target=\"_blank\">Dr. Debra Monticciolo\u003c/a>, a professor of radiology at Texas A&M Health Science Center College of Medicine. She chairs the radiology college's commission on breast imaging.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>While most women grasp the benefit of cancer screening, the harms of mammograms are likely less well-known to the average patient. Denise Grady at the New York Times outlined the risk of \"false positives,\" a finding on a mammogram which is suspicious, but only through additional testing, often including biopsies, can the finding be determined not to be cancer. From\u003ca href=\"http://www.nytimes.com/2015/10/21/health/breast-cancer-screening-guidelines.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news&_r=0\" target=\"_blank\"> the Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>A 2011 study cited in the article explaining the new [cancer society] guidelines found that 61 percent of women who had yearly mammograms starting at age 40 had at least one false positive by the time they were 50. Being tested every other year instead of every year can cut the false positive rate significantly, ... to about 42 percent from 61 percent.\u003c/p>\n\u003cp class=\"story-body-text story-content\">Some women consider false positives a small price to pay for the chance of identifying a cancer early. Others find being called back for more tests too nerve-racking.\u003c/p>\n\u003cp class=\"story-body-text story-content\">Another potential risk of mammography is overdiagnosis, meaning that some of the tiny cancers it finds might never progress or threaten the patient’s life. But because there is now no way to be sure which will turn dangerous, they are treated anyway.\u003c/p>\n\u003c/blockquote>\n\u003cp>The treatment can include surgery, radiation and chemotherapy.\u003c/p>\n\u003cp>\u003ca href=\"http://bcaction.org/2015/10/20/american-cancer-society-screening-guidelines-for-breast-cancer-baby-step-toward-evidence-based-recommendations/\" target=\"_blank\">In a statement,\u003c/a> the San Francisco-based Breast Cancer Action, which has long advocated for changes in screening guidelines, said it welcomed the \"long overdue step\" by the cancer society.\u003c/p>\n\u003cp>“After years of relentlessly promoting annual mammography for women age 40 and older and overstating the benefits of early detection, the ACS is finally starting to follow the evidence on the limitations of routine breast cancer screening for women at average risk,” said Karuna Jaggar, executive director of Breast Cancer Action.\u003c/p>\n\u003cp>\"The reality is tens of thousands of women each year would have been spared the harms of overtreatment if the ACS and other large cancer organizations had followed the evidence sooner,\" Jaggar said.\u003c/p>\n\u003cp>The cancer society says women ages 40-44 who wish to have mammograms should be informed of the test's risks and benefits.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force is in the process of \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/breast-cancer-screening1\" target=\"_blank\">updating its guidelines\u003c/a>, especially for women in their 40s, and now says: \"The decision to start screening mammography in women prior to age 50 years should be an individual one.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/95297/the-american-cancer-society-now-recommends-fewer-mammograms","authors":["240"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_176","stateofhealth_461","stateofhealth_397"],"featImg":"stateofhealth_95324","label":"stateofhealth"},"stateofhealth_69059":{"type":"posts","id":"stateofhealth_69059","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"69059","score":null,"sort":[1440777879000]},"guestAuthors":[],"slug":"poll-finds-most-women-believe-mammograms-should-be-done-annually","title":"Poll Finds Most Women Believe Mammograms Should Be Done Annually","publishDate":1440777879,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Most women 40 and older believe they should have mammograms every year to screen for breast cancer, the latest NPR-Truven Health Analytics health poll finds.\u003c/p>\n\u003cp>The finding is at odds with \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening\">current recommendations\u003c/a> by the \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Name/about-the-uspstf\">U.S. Preventive Services Task Force\u003c/a> that women with typical risks for breast cancer have screening mammograms every two years starting at age 50 and until they turn 75.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png\">\u003cimg class=\"aligncenter wp-image-69113 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png\" alt=\"Screen Shot 2015-08-28 at 9.02.03 AM\" width=\"793\" height=\"665\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png 793w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM-400x335.png 400w\" sizes=\"(max-width: 793px) 100vw, 793px\">\u003c/a>\u003cbr>\n\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png\">\u003cimg class=\"aligncenter wp-image-69115 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png\" alt=\"Screen Shot 2015-08-28 at 9.03.26 AM\" width=\"794\" height=\"733\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png 794w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM-400x369.png 400w\" sizes=\"(max-width: 794px) 100vw, 794px\">\u003c/a>The decision about mammograms for women in their 40s is a personal one. The task force found a small net benefit for biennial screening of women ages 40 to 49. The guidelines say women should take into account their health situation as well as their views on the benefits of early cancer detection and potential harms, such as unnecessary biopsies and surgery.\u003c/p>\n\u003cp>The USPSTF said there wasn't enough evidence about the benefits from mammograms for women age 75 and up to make a recommendation.\u003c/p>\n\u003cp>The task force is working on an \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/breast-cancer-screening1\">update to the mammography guidelines\u003c/a>, which have sparked controversy since they were last revised in 2009. The \u003ca href=\"http://www.npr.org/sections/health-shots/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\">thrust of the draft advice\u003c/a> is pretty much the same as it has been, but there's more nuanced discussion of the benefits and potential harms for women in their 40s.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The NPR-Truven Health poll found almost two-thirds of women ages 50 to 74 believe that they should have a mammogram annually. For women 40 to 49, the proportion drops to 56 percent. For women under 40, about 45 percent believe they should have a mammogram every year. Overall, 57 percent of women believe an annual mammogram is appropriate.\u003c/p>\n\u003cp>\"The Task Force is happy to see that women are making informed decisions with their doctor about breast cancer screening and continue to have access to mammography screening,\" Dr. Kirsten Bibbins-Domingo, vice chair of the USPSTF, and a professor at UC San Francisco, told Shots in a statement emailed after she reviewed the poll's findings.\u003c/p>\n\u003cp>\"Mammograms are an important tool in helping women avoid deaths from breast cancer. The value of mammography screening increases with age, with women ages 50 to 74 benefitting most from screening. In this age group, the evidence indicates that women get the best balance of benefits to harms when screening is done every 2 years.\"\u003c/p>\n\u003cp>She added, \"The decision to start regular mammography screening for women in their forties should be an individual one that women make in consultation with their doctors and after consideration of their health history, preferences, and how they value the potential benefits and harms of screening.\"\u003c/p>\n\u003cp>The task force's advice is influential, but its guidelines aren't the only ones around. The American Cancer Society, for instance, \u003ca href=\"http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs\">recommends that women 40 and older\u003c/a> \"have a mammogram every year and should continue to do so for as long as they are in good health.\"\u003c/p>\n\u003cp>After reviewing the poll's findings, Dr. Michael Taylor, Truven's chief medical officer, told Shots: \"There needs to be more education about the problem of false positives. If you do mammography every year starting at 40, you're going to find a lot of things that don't matter.\" There may be benefits for some women, but many will also be subjected to unnecessary biopsies and surgeries, he said. \"We don't think enough about the harms of interventions\" triggered by mammography, he said.\u003c/p>\n\u003cp>As for the belief that annual mammograms are best, \u003ca href=\"http://www.uofmhealth.org/profile/320/mark-fendrick-md\">Dr. A. Mark Fendrick\u003c/a>, a professor of internal medicine at the University of Michigan Medical School, says, \"It's much much harder to take away something that you're already doing than it is to start a behavior from time zero.\"\u003c/p>\n\u003cp>\"More isn't always better,\" Fendrick says about screening tests, including mammograms. But there are some people with family histories of disease or who have specific genetic risk factors who should be screened more often, he says.\u003c/p>\n\u003cp>Overall, 48 percent of respondents were aware that the Affordable Care Act \u003ca href=\"https://www.healthcare.gov/preventive-care-benefits/women/\">requires insurers to cover mammograms\u003c/a> without any out-of-pocket costs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The NPR-Truven Health Analytics Health Poll on mammograms was conducted in June. More than 3,000 women across the country were interviewed. The margin for error is plus or minus 1.8 percentage points. You can find the questions and full results of the latest poll \u003ca href=\"http://truvenhealth.com/Portals/0/NPR-Truven-Health-Poll/NPRPulseMammographyAug2015.pdf\">here\u003c/a>. For previous polls, \u003ca href=\"//www.npr.org/tags/155872782/npr-truven-health-analytics-health-poll/\">click here\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Poll+Finds+Most+Women+Believe+Mammograms+Should+Be+Done+Annually&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"Yet the U.S. Preventive Services Task Force recommendation is for screening mammograms every two years starting at age 50.","status":"publish","parent":0,"modified":1441324658,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":732},"headData":{"title":"Poll Finds Most Women Believe Mammograms Should Be Done Annually | KQED","description":"Yet the U.S. Preventive Services Task Force recommendation is for screening mammograms every two years starting at age 50.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"69059 http://ww2.kqed.org/stateofhealth/?p=69059","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/08/28/poll-finds-most-women-believe-mammograms-should-be-done-annually/","disqusTitle":"Poll Finds Most Women Believe Mammograms Should Be Done Annually","nprByline":"Scott Hensley","nprStoryId":"434292252","nprApiLink":"http://api.npr.org/query?id=434292252&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/08/28/434292252/poll-finds-most-women-believe-mammograms-should-be-done-annually?ft=nprml&f=434292252","nprRetrievedStory":"1","nprPubDate":"Fri, 28 Aug 2015 09:50:00 -0400","nprStoryDate":"Fri, 28 Aug 2015 09:40:00 -0400","nprLastModifiedDate":"Fri, 28 Aug 2015 09:50:03 -0400","path":"/stateofhealth/69059/poll-finds-most-women-believe-mammograms-should-be-done-annually","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most women 40 and older believe they should have mammograms every year to screen for breast cancer, the latest NPR-Truven Health Analytics health poll finds.\u003c/p>\n\u003cp>The finding is at odds with \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening\">current recommendations\u003c/a> by the \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Name/about-the-uspstf\">U.S. Preventive Services Task Force\u003c/a> that women with typical risks for breast cancer have screening mammograms every two years starting at age 50 and until they turn 75.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png\">\u003cimg class=\"aligncenter wp-image-69113 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png\" alt=\"Screen Shot 2015-08-28 at 9.02.03 AM\" width=\"793\" height=\"665\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM.png 793w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.02.03-AM-400x335.png 400w\" sizes=\"(max-width: 793px) 100vw, 793px\">\u003c/a>\u003cbr>\n\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png\">\u003cimg class=\"aligncenter wp-image-69115 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png\" alt=\"Screen Shot 2015-08-28 at 9.03.26 AM\" width=\"794\" height=\"733\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM.png 794w, https://ww2.kqed.org/app/uploads/sites/27/2015/08/Screen-Shot-2015-08-28-at-9.03.26-AM-400x369.png 400w\" sizes=\"(max-width: 794px) 100vw, 794px\">\u003c/a>The decision about mammograms for women in their 40s is a personal one. The task force found a small net benefit for biennial screening of women ages 40 to 49. The guidelines say women should take into account their health situation as well as their views on the benefits of early cancer detection and potential harms, such as unnecessary biopsies and surgery.\u003c/p>\n\u003cp>The USPSTF said there wasn't enough evidence about the benefits from mammograms for women age 75 and up to make a recommendation.\u003c/p>\n\u003cp>The task force is working on an \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/breast-cancer-screening1\">update to the mammography guidelines\u003c/a>, which have sparked controversy since they were last revised in 2009. The \u003ca href=\"http://www.npr.org/sections/health-shots/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\">thrust of the draft advice\u003c/a> is pretty much the same as it has been, but there's more nuanced discussion of the benefits and potential harms for women in their 40s.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The NPR-Truven Health poll found almost two-thirds of women ages 50 to 74 believe that they should have a mammogram annually. For women 40 to 49, the proportion drops to 56 percent. For women under 40, about 45 percent believe they should have a mammogram every year. Overall, 57 percent of women believe an annual mammogram is appropriate.\u003c/p>\n\u003cp>\"The Task Force is happy to see that women are making informed decisions with their doctor about breast cancer screening and continue to have access to mammography screening,\" Dr. Kirsten Bibbins-Domingo, vice chair of the USPSTF, and a professor at UC San Francisco, told Shots in a statement emailed after she reviewed the poll's findings.\u003c/p>\n\u003cp>\"Mammograms are an important tool in helping women avoid deaths from breast cancer. The value of mammography screening increases with age, with women ages 50 to 74 benefitting most from screening. In this age group, the evidence indicates that women get the best balance of benefits to harms when screening is done every 2 years.\"\u003c/p>\n\u003cp>She added, \"The decision to start regular mammography screening for women in their forties should be an individual one that women make in consultation with their doctors and after consideration of their health history, preferences, and how they value the potential benefits and harms of screening.\"\u003c/p>\n\u003cp>The task force's advice is influential, but its guidelines aren't the only ones around. The American Cancer Society, for instance, \u003ca href=\"http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs\">recommends that women 40 and older\u003c/a> \"have a mammogram every year and should continue to do so for as long as they are in good health.\"\u003c/p>\n\u003cp>After reviewing the poll's findings, Dr. Michael Taylor, Truven's chief medical officer, told Shots: \"There needs to be more education about the problem of false positives. If you do mammography every year starting at 40, you're going to find a lot of things that don't matter.\" There may be benefits for some women, but many will also be subjected to unnecessary biopsies and surgeries, he said. \"We don't think enough about the harms of interventions\" triggered by mammography, he said.\u003c/p>\n\u003cp>As for the belief that annual mammograms are best, \u003ca href=\"http://www.uofmhealth.org/profile/320/mark-fendrick-md\">Dr. A. Mark Fendrick\u003c/a>, a professor of internal medicine at the University of Michigan Medical School, says, \"It's much much harder to take away something that you're already doing than it is to start a behavior from time zero.\"\u003c/p>\n\u003cp>\"More isn't always better,\" Fendrick says about screening tests, including mammograms. But there are some people with family histories of disease or who have specific genetic risk factors who should be screened more often, he says.\u003c/p>\n\u003cp>Overall, 48 percent of respondents were aware that the Affordable Care Act \u003ca href=\"https://www.healthcare.gov/preventive-care-benefits/women/\">requires insurers to cover mammograms\u003c/a> without any out-of-pocket costs.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The NPR-Truven Health Analytics Health Poll on mammograms was conducted in June. More than 3,000 women across the country were interviewed. The margin for error is plus or minus 1.8 percentage points. You can find the questions and full results of the latest poll \u003ca href=\"http://truvenhealth.com/Portals/0/NPR-Truven-Health-Poll/NPRPulseMammographyAug2015.pdf\">here\u003c/a>. For previous polls, \u003ca href=\"//www.npr.org/tags/155872782/npr-truven-health-analytics-health-poll/\">click here\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Poll+Finds+Most+Women+Believe+Mammograms+Should+Be+Done+Annually&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/69059/poll-finds-most-women-believe-mammograms-should-be-done-annually","authors":["byline_stateofhealth_69059"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_176","stateofhealth_397"],"featImg":"stateofhealth_69060","label":"stateofhealth"},"stateofhealth_45506":{"type":"posts","id":"stateofhealth_45506","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"45506","score":null,"sort":[1436375471000]},"guestAuthors":[],"slug":"mammograms-may-not-reduce-breast-cancer-deaths-study-finds","title":"More Mammograms May Not Reduce Breast Cancer Deaths, Study Finds","publishDate":1436375471,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Here's more evidence that mammograms don't always deliver the results that women want. They find more small cancers, but don't lower a woman's risk of dying of breast cancer, a study finds.\u003c/p>\n\u003cp>The study looked at data from 547 U.S. counties that reported the percentage of women over age 40 who had a screening mammogram between 1998 and 2000. More than 16 million women lived in those counties, and 53,207 were diagnosed with breast cancer in 2000.\u003c/p>\n\u003cp>Over the next 10 years, 15 percent of the women died of breast cancer.\u003c/p>\n\u003cp>There was a lot of county-to-county variation in the number of women who got screening mammograms, from 38 percent to 78 percent. So you'd think that the counties that did a better job at screening would have fewer breast cancer deaths.\u003c/p>\n\u003cp>That wasn't the case. The risk of death from breast cancer over 10 years was pretty much the same.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But the scanning did find more cancers. For every 10 percent increase in screening, the number of cancers found rose by 16 percent, the study found. The \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2363025\" target=\"_blank\">results \u003c/a>were reported Tuesday in \u003cem>JAMA Internal Medicine.\u003c/em> This, the authors write, means \"the most prominent effect of screening mammography is overdiagnosis.\"\u003c/p>\n\u003cp>By that they mean identifying abnormalities that will never cause illness or death in the patient's lifetime. Overdiagnosis has become an issue in screening for breast, \u003ca href=\"http://www.npr.org/sections/health-shots/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says\" target=\"_blank\">prostate\u003c/a> and \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/21/280692601/overdiagnosis-could-be-behind-jump-in-thyroid-cancer-cases\" target=\"_blank\">thyroid cancer\u003c/a>.\u003c/p>\n\u003cp>So what's a woman supposed to do with this information? After giving a big fat dis to mammography, the authors write, \"Nonetheless, we do not believe that the right rate of screening mammography is zero.\" Focusing screening on higher-risk women would help, they say, as well as more watchful waiting instead of immediate treatment.\u003c/p>\n\u003cp>The study has its limitations, because it's comparing large groups of people, rather than tracking the health of individual women from mammogram on. Or it may be that even with this large number of cases, deaths are still rare enough that they're missed in this sort of study. Other studies have found a 20 percent reduction in breast cancer deaths as a result of mammography.\u003c/p>\n\u003cp>This is just the latest study pointing out the \u003ca href=\"http://www.npr.org/sections/health-shots/2014/04/01/297826238/review-finds-mammographys-benefits-overplayed-harms-dismissed\" target=\"_blank\">problem with overdiagnosis\u003c/a> of breast cancer.\u003c/p>\n\u003cp>\"This study shows that the more we look, the more you find,\" says Joann Elmore, a professor of medicine at the University of Washington who wrote a \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2363022\" target=\"_blank\">commentary\u003c/a> accompanying the study. \"The more you screen, the more likely you are to detect early precancerous abnormalities like ductal carcinoma in situ and early-stage cancer.\"\u003c/p>\n\u003cp>It's not clear how many women are overdiagnosed; Elmore says 10 to 20 percent may be a good estimate. But with the current tests, there's no way for a woman to know if she's in that 10 to 20 percent or if she really does have a dangerous cancer. Thus most women who get a diagnosis of DCIS or early-stage invasive cancer opt for treatment, which can mean surgery, radiation or chemotherapy.\u003c/p>\n\u003cp>\"That is so hard,\" Elmore says. \"I really feel for those women. I need help both figuring out how to explain this to women, and I need better research helping me look at the tissue and figure out whether these women are overdiagnosed or not.\"\u003c/p>\n\u003cp>Elmore studies the reliability of breast cancer screening, and published a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25781441\" target=\"_blank\">study\u003c/a> in March that found that pathologists often misidentify DCIS and early-stage cancers when reading biopsies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The medical community has come to accept that overdiagnosis exists, Elmore says. \"This is something that wasn't even considered when I was in med school years ago. We're slowly realizing that we are taking healthy people and maybe potentially giving them harm.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=More+Mammograms+May+Not+Always+Mean+Fewer+Cancer+Deaths&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"Getting more women in for screening mammograms didn't lower death rates from breast cancer. But more small cancers were found.","status":"publish","parent":0,"modified":1436375614,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":639},"headData":{"title":"More Mammograms May Not Reduce Breast Cancer Deaths, Study Finds | KQED","description":"Getting more women in for screening mammograms didn't lower death rates from breast cancer. But more small cancers were found.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"45506 http://ww2.kqed.org/stateofhealth/?p=45506","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/07/08/mammograms-may-not-reduce-breast-cancer-deaths-study-finds/","disqusTitle":"More Mammograms May Not Reduce Breast Cancer Deaths, Study Finds","nprByline":"Nancy Shute","nprStoryId":"420585286","nprApiLink":"http://api.npr.org/query?id=420585286&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/07/07/420585286/more-mammograms-may-not-always-mean-fewer-cancer-deaths?ft=nprml&f=420585286","nprRetrievedStory":"1","nprPubDate":"Wed, 08 Jul 2015 10:57:00 -0400","nprStoryDate":"Tue, 07 Jul 2015 11:57:00 -0400","nprLastModifiedDate":"Wed, 08 Jul 2015 10:57:16 -0400","path":"/stateofhealth/45506/mammograms-may-not-reduce-breast-cancer-deaths-study-finds","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Here's more evidence that mammograms don't always deliver the results that women want. They find more small cancers, but don't lower a woman's risk of dying of breast cancer, a study finds.\u003c/p>\n\u003cp>The study looked at data from 547 U.S. counties that reported the percentage of women over age 40 who had a screening mammogram between 1998 and 2000. More than 16 million women lived in those counties, and 53,207 were diagnosed with breast cancer in 2000.\u003c/p>\n\u003cp>Over the next 10 years, 15 percent of the women died of breast cancer.\u003c/p>\n\u003cp>There was a lot of county-to-county variation in the number of women who got screening mammograms, from 38 percent to 78 percent. So you'd think that the counties that did a better job at screening would have fewer breast cancer deaths.\u003c/p>\n\u003cp>That wasn't the case. The risk of death from breast cancer over 10 years was pretty much the same.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But the scanning did find more cancers. For every 10 percent increase in screening, the number of cancers found rose by 16 percent, the study found. The \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2363025\" target=\"_blank\">results \u003c/a>were reported Tuesday in \u003cem>JAMA Internal Medicine.\u003c/em> This, the authors write, means \"the most prominent effect of screening mammography is overdiagnosis.\"\u003c/p>\n\u003cp>By that they mean identifying abnormalities that will never cause illness or death in the patient's lifetime. Overdiagnosis has become an issue in screening for breast, \u003ca href=\"http://www.npr.org/sections/health-shots/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says\" target=\"_blank\">prostate\u003c/a> and \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/21/280692601/overdiagnosis-could-be-behind-jump-in-thyroid-cancer-cases\" target=\"_blank\">thyroid cancer\u003c/a>.\u003c/p>\n\u003cp>So what's a woman supposed to do with this information? After giving a big fat dis to mammography, the authors write, \"Nonetheless, we do not believe that the right rate of screening mammography is zero.\" Focusing screening on higher-risk women would help, they say, as well as more watchful waiting instead of immediate treatment.\u003c/p>\n\u003cp>The study has its limitations, because it's comparing large groups of people, rather than tracking the health of individual women from mammogram on. Or it may be that even with this large number of cases, deaths are still rare enough that they're missed in this sort of study. Other studies have found a 20 percent reduction in breast cancer deaths as a result of mammography.\u003c/p>\n\u003cp>This is just the latest study pointing out the \u003ca href=\"http://www.npr.org/sections/health-shots/2014/04/01/297826238/review-finds-mammographys-benefits-overplayed-harms-dismissed\" target=\"_blank\">problem with overdiagnosis\u003c/a> of breast cancer.\u003c/p>\n\u003cp>\"This study shows that the more we look, the more you find,\" says Joann Elmore, a professor of medicine at the University of Washington who wrote a \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2363022\" target=\"_blank\">commentary\u003c/a> accompanying the study. \"The more you screen, the more likely you are to detect early precancerous abnormalities like ductal carcinoma in situ and early-stage cancer.\"\u003c/p>\n\u003cp>It's not clear how many women are overdiagnosed; Elmore says 10 to 20 percent may be a good estimate. But with the current tests, there's no way for a woman to know if she's in that 10 to 20 percent or if she really does have a dangerous cancer. Thus most women who get a diagnosis of DCIS or early-stage invasive cancer opt for treatment, which can mean surgery, radiation or chemotherapy.\u003c/p>\n\u003cp>\"That is so hard,\" Elmore says. \"I really feel for those women. I need help both figuring out how to explain this to women, and I need better research helping me look at the tissue and figure out whether these women are overdiagnosed or not.\"\u003c/p>\n\u003cp>Elmore studies the reliability of breast cancer screening, and published a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25781441\" target=\"_blank\">study\u003c/a> in March that found that pathologists often misidentify DCIS and early-stage cancers when reading biopsies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The medical community has come to accept that overdiagnosis exists, Elmore says. \"This is something that wasn't even considered when I was in med school years ago. We're slowly realizing that we are taking healthy people and maybe potentially giving them harm.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=More+Mammograms+May+Not+Always+Mean+Fewer+Cancer+Deaths&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/45506/mammograms-may-not-reduce-breast-cancer-deaths-study-finds","authors":["byline_stateofhealth_45506"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_176","stateofhealth_235"],"featImg":"stateofhealth_45507","label":"stateofhealth"},"stateofhealth_28436":{"type":"posts","id":"stateofhealth_28436","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"28436","score":null,"sort":[1432079041000]},"guestAuthors":[],"slug":"not-all-women-with-dense-breasts-are-at-high-risk-of-cancer","title":"Not All Women with Dense Breasts Are at High Risk of Cancer","publishDate":1432079041,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Almost half the states -- including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/californias-breast-density-notification-law-goes-into-effect/\" target=\"_blank\">California \u003c/a>-- now require doctors to tell women if they have dense breasts. That's because women with dense breast are both at higher risk of breast cancer and those cancers are harder to find.\u003c/p>\n\u003cp>But not all women with dense breasts have the same risks, a study says.\u003c/p>\n\u003cp>Those differences need to be taken into account when figuring out each woman's risk of breast cancer, the study says, and also weighed against other factors, including family history, age and ethnicity.\u003c/p>\n\u003cp>The researchers looked at the records of 365,426 women who had a normal mammogram, then looked to see which ones were diagnosed with breast cancer within a year — an \"interval cancer\" that may have been missed by the mammogram.\u003c/p>\n\u003cp>All told, 47 percent of the women in the study had dense breasts. But just half of those women had a higher cancer risk. The women who got cancer were more likely to be older and white, have a family history of breast cancer, and to have \"heterogeneously\" or \"extremely\" dense breasts, the top two categories of breast density.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The \u003ca href=\"http://annals.org/article.aspx?articleid=2293233\" target=\"_blank\">results\u003c/a> were published this week in Annals of Internal Medicine.\u003c/p>\n\u003cp>Breast cancer advocates have been \u003ca href=\"http://www.areyoudenseadvocacy.org\" target=\"_blank\">pushing for state and federal laws\u003c/a> requiring that women be told if they have dense breasts, so they can get extra screening with ultrasound or MRI. That screening can find more cancers in dense breasts, but it can also lead to \u003ca href=\"http://www.npr.org/sections/health-shots/2015/04/16/399946509/letters-about-dense-breasts-can-lead-to-more-questions-than-answers\" target=\"_blank\">more false positives and needless surgery.\u003c/a>\u003c/p>\n\u003cp>This study makes the point that women need to know not just about breast density, but what kind of breast density, and other risk factors, too.\u003c/p>\n\u003cp>To help explain these factors more fully, we called up Dr. Karla Kerlikowske, a professor of medicine at UC San Francisco and lead author of the study. The conversation has been edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>Your study looks at breast cancer risk using not just breast density but also family history, age and ethnicity. Why is that?\u003c/strong>\u003c/p>\n\u003cp>About 45 percent of women have dense breasts; that's a large number of women. But the sensitivity of mammograms is such that we're not missing 45 percent of cancers. So can we narrow it down to women who are at higher risk of cancer, and especially women at higher risk of advanced cancer? Then if we did supplemental imaging of women in that group, it might help them.\u003c/p>\n\u003cp>\u003cstrong>How would I figure out the other risk factors besides breast density?\u003c/strong>\u003c/p>\n\u003cp>You can use our \u003ca href=\"https://tools.bcsc-scc.org/BC5yearRisk/intro.htm\" target=\"_blank\">Breast Cancer Surveillance Consortium Risk Calculator\u003c/a>; it looks at age, race, family history, history of biopsy and breast density. Ours is the only risk calculator that has breast density in it. We actually validated it in another mammography population. And it's an \u003ca href=\"https://itunes.apple.com/us/app/bcsc-risk-calculator/id919034661?mt=8\" target=\"_blank\">app\u003c/a>; just type in \"BCSC Risk Calculator\" and download.\u003c/p>\n\u003cp>\u003cstrong>I looked at the calculator, and even though I've been told I have dense breasts I realize I have no idea if they're heterogenous or extremely dense, which are the higher-risk categories. How do I find that out?\u003c/strong>\u003c/p>\n\u003cp>The provider who ordered the test will get that information. You'd have to ask the provider; it's in the mammography report. My understanding from the bills in Congress is that you'd actually be told what your density is; if you're fatty or scattered or heterogenous or extremely dense. All women would be informed, and they would know the category. If I have fatty breasts I'd like to know that, too, because then I'm at really low risk.\u003c/p>\n\u003cp>\u003cstrong>Are you telling your patients that?\u003c/strong>\u003c/p>\n\u003cp>It sort of depends. If I don't think they're at high risk of an interval cancer I tend not to worry them too much. If they're at high risk then I have a discussion with them. If they have fatty breasts I let them know, wow, you're really at low risk for cancer.\u003c/p>\n\u003cp>\u003cstrong>It feels like we're still struggling with who really needs the extra scans. How will we figure that out?\u003c/strong>\u003c/p>\n\u003cp>Now that we know who these high-risk groups are, we need to know how supplemental screening works in those high-risk groups. If we add ultrasound, do we miss less cancer? If we add MRI, do we miss less cancer? We have data on both of them, and we're in the process of analyzing them.\u003c/p>\n\u003cp>\u003cstrong>When will we find out?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>I'm hoping sometime this summer.\u003c/p>\n\n","blocks":[],"excerpt":"Many other factors should be weighed before worrying about additional scans, like ultrasound and MRI.","status":"publish","parent":0,"modified":1432079041,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":748},"headData":{"title":"Not All Women with Dense Breasts Are at High Risk of Cancer | KQED","description":"Many other factors should be weighed before worrying about additional scans, like ultrasound and MRI.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"28436 http://ww2.kqed.org/stateofhealth/?p=28436","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/05/19/not-all-women-with-dense-breasts-are-at-high-risk-of-cancer/","disqusTitle":"Not All Women with Dense Breasts Are at High Risk of Cancer","nprByline":"Nancy Shute, NPR","path":"/stateofhealth/28436/not-all-women-with-dense-breasts-are-at-high-risk-of-cancer","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Almost half the states -- including \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/03/29/californias-breast-density-notification-law-goes-into-effect/\" target=\"_blank\">California \u003c/a>-- now require doctors to tell women if they have dense breasts. That's because women with dense breast are both at higher risk of breast cancer and those cancers are harder to find.\u003c/p>\n\u003cp>But not all women with dense breasts have the same risks, a study says.\u003c/p>\n\u003cp>Those differences need to be taken into account when figuring out each woman's risk of breast cancer, the study says, and also weighed against other factors, including family history, age and ethnicity.\u003c/p>\n\u003cp>The researchers looked at the records of 365,426 women who had a normal mammogram, then looked to see which ones were diagnosed with breast cancer within a year — an \"interval cancer\" that may have been missed by the mammogram.\u003c/p>\n\u003cp>All told, 47 percent of the women in the study had dense breasts. But just half of those women had a higher cancer risk. The women who got cancer were more likely to be older and white, have a family history of breast cancer, and to have \"heterogeneously\" or \"extremely\" dense breasts, the top two categories of breast density.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://annals.org/article.aspx?articleid=2293233\" target=\"_blank\">results\u003c/a> were published this week in Annals of Internal Medicine.\u003c/p>\n\u003cp>Breast cancer advocates have been \u003ca href=\"http://www.areyoudenseadvocacy.org\" target=\"_blank\">pushing for state and federal laws\u003c/a> requiring that women be told if they have dense breasts, so they can get extra screening with ultrasound or MRI. That screening can find more cancers in dense breasts, but it can also lead to \u003ca href=\"http://www.npr.org/sections/health-shots/2015/04/16/399946509/letters-about-dense-breasts-can-lead-to-more-questions-than-answers\" target=\"_blank\">more false positives and needless surgery.\u003c/a>\u003c/p>\n\u003cp>This study makes the point that women need to know not just about breast density, but what kind of breast density, and other risk factors, too.\u003c/p>\n\u003cp>To help explain these factors more fully, we called up Dr. Karla Kerlikowske, a professor of medicine at UC San Francisco and lead author of the study. The conversation has been edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>Your study looks at breast cancer risk using not just breast density but also family history, age and ethnicity. Why is that?\u003c/strong>\u003c/p>\n\u003cp>About 45 percent of women have dense breasts; that's a large number of women. But the sensitivity of mammograms is such that we're not missing 45 percent of cancers. So can we narrow it down to women who are at higher risk of cancer, and especially women at higher risk of advanced cancer? Then if we did supplemental imaging of women in that group, it might help them.\u003c/p>\n\u003cp>\u003cstrong>How would I figure out the other risk factors besides breast density?\u003c/strong>\u003c/p>\n\u003cp>You can use our \u003ca href=\"https://tools.bcsc-scc.org/BC5yearRisk/intro.htm\" target=\"_blank\">Breast Cancer Surveillance Consortium Risk Calculator\u003c/a>; it looks at age, race, family history, history of biopsy and breast density. Ours is the only risk calculator that has breast density in it. We actually validated it in another mammography population. And it's an \u003ca href=\"https://itunes.apple.com/us/app/bcsc-risk-calculator/id919034661?mt=8\" target=\"_blank\">app\u003c/a>; just type in \"BCSC Risk Calculator\" and download.\u003c/p>\n\u003cp>\u003cstrong>I looked at the calculator, and even though I've been told I have dense breasts I realize I have no idea if they're heterogenous or extremely dense, which are the higher-risk categories. How do I find that out?\u003c/strong>\u003c/p>\n\u003cp>The provider who ordered the test will get that information. You'd have to ask the provider; it's in the mammography report. My understanding from the bills in Congress is that you'd actually be told what your density is; if you're fatty or scattered or heterogenous or extremely dense. All women would be informed, and they would know the category. If I have fatty breasts I'd like to know that, too, because then I'm at really low risk.\u003c/p>\n\u003cp>\u003cstrong>Are you telling your patients that?\u003c/strong>\u003c/p>\n\u003cp>It sort of depends. If I don't think they're at high risk of an interval cancer I tend not to worry them too much. If they're at high risk then I have a discussion with them. If they have fatty breasts I let them know, wow, you're really at low risk for cancer.\u003c/p>\n\u003cp>\u003cstrong>It feels like we're still struggling with who really needs the extra scans. How will we figure that out?\u003c/strong>\u003c/p>\n\u003cp>Now that we know who these high-risk groups are, we need to know how supplemental screening works in those high-risk groups. If we add ultrasound, do we miss less cancer? If we add MRI, do we miss less cancer? We have data on both of them, and we're in the process of analyzing them.\u003c/p>\n\u003cp>\u003cstrong>When will we find out?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>I'm hoping sometime this summer.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/28436/not-all-women-with-dense-breasts-are-at-high-risk-of-cancer","authors":["byline_stateofhealth_28436"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_176"],"featImg":"stateofhealth_28449","label":"stateofhealth"},"stateofhealth_25008":{"type":"posts","id":"stateofhealth_25008","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"25008","score":null,"sort":[1429636963000]},"guestAuthors":[],"slug":"mammogram-in-your-40s-still-a-personal-decision-task-force-says","title":"Mammogram in Your 40s Still a Personal Decision, Task Force Says","publishDate":1429636963,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_25011\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS8553_128959324.jpg\">\u003cimg class=\"size-large wp-image-25011\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS8553_128959324-640x417.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Katherine Hobson,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\" href=\"http://www.npr.org/blogs/health/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\" target=\"_blank\">NPR \u003c/a>\u003c/p>\n\u003cp>In 2009, I was among the scrum of reporters covering the controversial advice from the U.S. Preventive Services Task Force that women in their 40s think twice about regular mammograms. The task force pointed out that the net benefits in younger women were small and said women should weigh the pros and cons of screening before making a decision.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The suggested changes to the updated mammography guidelines are small ones. \u003c/aside>\n\u003cp>Those guidelines kicked off a heated debate about the benefits and harms of mammography that is rekindled with every new study.\u003c/p>\n\u003cp>I wasn't yet 40 back then, but what I learned about mammograms stuck with me: I haven't yet had the test. I took to heart the warnings of the task force and of many other physicians that mammography has minuses as well as pluses. I wasn't so worried about a false positive result. But I was very concerned about overdiagnosis, or being diagnosed with and treated for a cancer that would never have caused me any harm.\u003c/p>\n\u003cp>\u003c!--more-->I'm now 43 and am thinking that I should get a mammogram. So when I found out the USPSTF was doing a routine update of its breast cancer screening recommendations, I hoped it would help me decide.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As it turns out, the suggested changes to the recommendations — which are in draft form and may be altered after a \u003ca href=\"http://screeningforbreastcancer.org/\" target=\"_blank\">public comment\u003c/a> period — are small ones.\u003c/p>\n\u003cp>What is new? For the first time, the task force looked at the evidence behind 3-D mammography, also known as tomosynthesis. The USPSTF said there's \u003ca href=\"http://www.npr.org/blogs/health/2014/06/24/325216641/3-d-mammography-finds-more-tumors-but-questions-remain\" target=\"_blank\">not enough evidence\u003c/a> to make a recommendation for or against using the technology to screen women. It also said there was \u003ca href=\"http://www.npr.org/blogs/health/2015/04/16/399946509/letters-about-dense-breasts-can-lead-to-more-questions-than-answers\">insufficient evidence\u003c/a> to say whether women with dense breasts should have screening with MRI, ultrasound or other methods in addition to mammography.\u003c/p>\n\u003cp>\u003cstrong>2009 Advice Unchanged\u003c/strong>\u003c/p>\n\u003cp>But the task force's basic advice has not changed:\u003c/p>\n\u003cul>\n\u003cli>The group recommends that \u003cstrong>women ages 50-74\u003c/strong> get a screening mammogram every two years.\u003c/li>\n\u003cli>And\u003cstrong> women between ages 40 and 49\u003c/strong> should make their own decision, in consultation with their doctors, based on \"health history, preferences and how they value the different potential benefits and harms of screening.\" (Women with a family history of breast cancer may benefit more from screening in their 40s, the task force says.)\u003c/li>\n\u003cli>The task force reiterates that there isn't enough evidence to say whether or not women \u003cstrong>75 and older\u003c/strong> should be routinely screened.\u003c/li>\n\u003c/ul>\n\u003cp>Screening mammography means looking for potential cancer in women who are healthy and who don't have any symptoms. People with symptoms should be seen by a doctor, no matter their age. And these recommendations don't apply to women who have previously been diagnosed with the disease or who are at higher risk because of a genetic mutation or other condition.\u003c/p>\n\u003cp>\"We want to reaffirm the importance of mammography to help prevent death from breast cancer,\" \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Biography/Kirsten-Bibbins-Domingo\">Kirsten Bibbins-Domingo\u003c/a>, a physician at UC San Francisco and vice chairwoman of the USPSTF, said.\u003c/p>\n\u003cp>And mammograms do save lives in women between 40 and 49 — it's just that there's a disproportionate level of harm.\u003c/p>\n\u003cp>The USPSTF's draft includes statistical models estimating the lifetime consequences of screening women from ages 50-74 and also from 40-74. For every 1,000 women screened, the model finds that screening women in their 40s means an estimated one additional breast cancer death averted (from eight to seven), but with 576 additional false positive tests (1,529 vs. 953), 58 unnecessary biopsies (204 vs. 146) and two additional overdiagnosed tumors (20 vs. 18).\u003c/p>\n\u003cp>The draft recommendations also repeat the USPSTF's earlier advice that women be screened every other year rather than annually, said Bibbins-Domingo. That time frame provides \"most of the benefits while minimizing the harm,\" she said.\u003c/p>\n\u003cp>\u003cstrong>Other Groups' Guidelines Differ\u003c/strong>\u003c/p>\n\u003cp>Guidelines from medical groups differ on when a woman should start regular screening.\u003c/p>\n\u003cp>The American Cancer Society, for example, \u003ca href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\">recommends\u003c/a> yearly mammograms starting at age 40. Richard Wender, chief cancer control officer of the ACS, says there's much common ground between the guidelines, however. \"The task force reconfirmed its conclusion that mammography reduced breast cancer deaths for women in their 40s,\" he said. The ACS is reviewing its own breast cancer screening guidelines this year.\u003c/p>\n\u003cp>As for my fear of overdiagnosis? Wender said it's an issue, but the exact extent of the problem is unknown. And, he added, much of overdiagnosis happens in women with \u003ca href=\"http://www.npr.org/blogs/health/2013/08/05/208239545/when-treating-abnormal-breast-cells-sometimes-less-is-more\" target=\"_blank\">ductal carcinoma in situ\u003c/a>, which is Stage 0 cancer that hasn't yet become invasive.\u003c/p>\n\u003cp>In the not-so-far future, molecular tools may help physicians give those women a more accurate prognosis, Wender says, so those at lower risk can opt for less aggressive treatments — or simply watchful waiting. \"The next 10 years are going to be good news for helping women really make decisions about treatment, not just about screening,\" he said.\u003c/p>\n\u003cp>So why am I planning to get a mammogram this year? In part, simply because I'm a few years older. The 50-year cutoff isn't a clear line in the sand, and as Bibbins-Domingo told me, the value of the test increases with age.\u003c/p>\n\u003cp>But to be honest, the main change has little to do with the numbers. I now have a young daughter, and my fear of dying prematurely has become far, far stronger than my fear of getting chemo or even a mastectomy I might not need. I understand the statistics, but I'd feel like a total jerk if I didn't get screened and that unlucky statistic were me.\u003c/p>\n\u003cp>And on the flip side, if my mammogram did show breast cancer and I was treated successfully, I'd probably be grateful I'd been screened, even if there was no way to know whether the treatment was necessary.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In other words, then and now, I weighed the benefits and the risks and made my own decision, which is exactly what the USPSTF suggests.\u003c/p>\n\n","blocks":[],"excerpt":"Federal panel's 2009 recommendations ignited a firestorm. But the group is staying the course.","status":"publish","parent":0,"modified":1429670518,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":1030},"headData":{"title":"Mammogram in Your 40s Still a Personal Decision, Task Force Says | KQED","description":"Federal panel's 2009 recommendations ignited a firestorm. But the group is staying the course.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"25008 http://blogs.kqed.org/stateofhealth/?p=25008","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/04/21/mammogram-in-your-40s-still-a-personal-decision-task-force-says/","disqusTitle":"Mammogram in Your 40s Still a Personal Decision, Task Force Says","path":"/stateofhealth/25008/mammogram-in-your-40s-still-a-personal-decision-task-force-says","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_25011\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS8553_128959324.jpg\">\u003cimg class=\"size-large wp-image-25011\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS8553_128959324-640x417.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Katherine Hobson,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\" href=\"http://www.npr.org/blogs/health/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\" target=\"_blank\">NPR \u003c/a>\u003c/p>\n\u003cp>In 2009, I was among the scrum of reporters covering the controversial advice from the U.S. Preventive Services Task Force that women in their 40s think twice about regular mammograms. The task force pointed out that the net benefits in younger women were small and said women should weigh the pros and cons of screening before making a decision.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The suggested changes to the updated mammography guidelines are small ones. \u003c/aside>\n\u003cp>Those guidelines kicked off a heated debate about the benefits and harms of mammography that is rekindled with every new study.\u003c/p>\n\u003cp>I wasn't yet 40 back then, but what I learned about mammograms stuck with me: I haven't yet had the test. I took to heart the warnings of the task force and of many other physicians that mammography has minuses as well as pluses. I wasn't so worried about a false positive result. But I was very concerned about overdiagnosis, or being diagnosed with and treated for a cancer that would never have caused me any harm.\u003c/p>\n\u003cp>\u003c!--more-->I'm now 43 and am thinking that I should get a mammogram. So when I found out the USPSTF was doing a routine update of its breast cancer screening recommendations, I hoped it would help me decide.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As it turns out, the suggested changes to the recommendations — which are in draft form and may be altered after a \u003ca href=\"http://screeningforbreastcancer.org/\" target=\"_blank\">public comment\u003c/a> period — are small ones.\u003c/p>\n\u003cp>What is new? For the first time, the task force looked at the evidence behind 3-D mammography, also known as tomosynthesis. The USPSTF said there's \u003ca href=\"http://www.npr.org/blogs/health/2014/06/24/325216641/3-d-mammography-finds-more-tumors-but-questions-remain\" target=\"_blank\">not enough evidence\u003c/a> to make a recommendation for or against using the technology to screen women. It also said there was \u003ca href=\"http://www.npr.org/blogs/health/2015/04/16/399946509/letters-about-dense-breasts-can-lead-to-more-questions-than-answers\">insufficient evidence\u003c/a> to say whether women with dense breasts should have screening with MRI, ultrasound or other methods in addition to mammography.\u003c/p>\n\u003cp>\u003cstrong>2009 Advice Unchanged\u003c/strong>\u003c/p>\n\u003cp>But the task force's basic advice has not changed:\u003c/p>\n\u003cul>\n\u003cli>The group recommends that \u003cstrong>women ages 50-74\u003c/strong> get a screening mammogram every two years.\u003c/li>\n\u003cli>And\u003cstrong> women between ages 40 and 49\u003c/strong> should make their own decision, in consultation with their doctors, based on \"health history, preferences and how they value the different potential benefits and harms of screening.\" (Women with a family history of breast cancer may benefit more from screening in their 40s, the task force says.)\u003c/li>\n\u003cli>The task force reiterates that there isn't enough evidence to say whether or not women \u003cstrong>75 and older\u003c/strong> should be routinely screened.\u003c/li>\n\u003c/ul>\n\u003cp>Screening mammography means looking for potential cancer in women who are healthy and who don't have any symptoms. People with symptoms should be seen by a doctor, no matter their age. And these recommendations don't apply to women who have previously been diagnosed with the disease or who are at higher risk because of a genetic mutation or other condition.\u003c/p>\n\u003cp>\"We want to reaffirm the importance of mammography to help prevent death from breast cancer,\" \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Biography/Kirsten-Bibbins-Domingo\">Kirsten Bibbins-Domingo\u003c/a>, a physician at UC San Francisco and vice chairwoman of the USPSTF, said.\u003c/p>\n\u003cp>And mammograms do save lives in women between 40 and 49 — it's just that there's a disproportionate level of harm.\u003c/p>\n\u003cp>The USPSTF's draft includes statistical models estimating the lifetime consequences of screening women from ages 50-74 and also from 40-74. For every 1,000 women screened, the model finds that screening women in their 40s means an estimated one additional breast cancer death averted (from eight to seven), but with 576 additional false positive tests (1,529 vs. 953), 58 unnecessary biopsies (204 vs. 146) and two additional overdiagnosed tumors (20 vs. 18).\u003c/p>\n\u003cp>The draft recommendations also repeat the USPSTF's earlier advice that women be screened every other year rather than annually, said Bibbins-Domingo. That time frame provides \"most of the benefits while minimizing the harm,\" she said.\u003c/p>\n\u003cp>\u003cstrong>Other Groups' Guidelines Differ\u003c/strong>\u003c/p>\n\u003cp>Guidelines from medical groups differ on when a woman should start regular screening.\u003c/p>\n\u003cp>The American Cancer Society, for example, \u003ca href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\">recommends\u003c/a> yearly mammograms starting at age 40. Richard Wender, chief cancer control officer of the ACS, says there's much common ground between the guidelines, however. \"The task force reconfirmed its conclusion that mammography reduced breast cancer deaths for women in their 40s,\" he said. The ACS is reviewing its own breast cancer screening guidelines this year.\u003c/p>\n\u003cp>As for my fear of overdiagnosis? Wender said it's an issue, but the exact extent of the problem is unknown. And, he added, much of overdiagnosis happens in women with \u003ca href=\"http://www.npr.org/blogs/health/2013/08/05/208239545/when-treating-abnormal-breast-cells-sometimes-less-is-more\" target=\"_blank\">ductal carcinoma in situ\u003c/a>, which is Stage 0 cancer that hasn't yet become invasive.\u003c/p>\n\u003cp>In the not-so-far future, molecular tools may help physicians give those women a more accurate prognosis, Wender says, so those at lower risk can opt for less aggressive treatments — or simply watchful waiting. \"The next 10 years are going to be good news for helping women really make decisions about treatment, not just about screening,\" he said.\u003c/p>\n\u003cp>So why am I planning to get a mammogram this year? In part, simply because I'm a few years older. The 50-year cutoff isn't a clear line in the sand, and as Bibbins-Domingo told me, the value of the test increases with age.\u003c/p>\n\u003cp>But to be honest, the main change has little to do with the numbers. I now have a young daughter, and my fear of dying prematurely has become far, far stronger than my fear of getting chemo or even a mastectomy I might not need. I understand the statistics, but I'd feel like a total jerk if I didn't get screened and that unlucky statistic were me.\u003c/p>\n\u003cp>And on the flip side, if my mammogram did show breast cancer and I was treated successfully, I'd probably be grateful I'd been screened, even if there was no way to know whether the treatment was necessary.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In other words, then and now, I weighed the benefits and the risks and made my own decision, which is exactly what the USPSTF suggests.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/25008/mammogram-in-your-40s-still-a-personal-decision-task-force-says","authors":["8344"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_176","stateofhealth_461"],"featImg":"stateofhealth_25011","label":"stateofhealth"},"stateofhealth_24926":{"type":"posts","id":"stateofhealth_24926","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"24926","score":null,"sort":[1428944853000]},"guestAuthors":[],"slug":"the-hidden-cost-of-mammograms-more-testing-and-overtreatment","title":"The Hidden Cost of Mammograms: More Testing and Overtreatment","publishDate":1428944853,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_24928\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000016019343_Large.jpg\">\u003cimg class=\"size-large wp-image-24928\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000016019343_Large-640x427.jpg\" alt=\"Instead of having mammograms according to age, some doctors think screening should be based on a woman's overall risk for breast cancer. (Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Instead of having mammograms according to age, some doctors think screening should be based on a woman's overall risk for breast cancer. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Patti Neighmond,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/04/13/398818949/the-hidden-cost-of-mammograms-more-testing-and-overtreatment\" href=\"http://www.npr.org/blogs/health/2015/04/13/398818949/the-hidden-cost-of-mammograms-more-testing-and-overtreatment\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>There's no question mammograms can save lives by detecting breast cancer early. But they can also result in unnecessary testing and treatment that can be alarming and costly.\u003c/p>\n\u003cp>In fact, each year the U.S. spends $4 billion on follow-up tests and treatments that result from inaccurate mammograms, scientists \u003ca href=\"http://content.healthaffairs.org/content/34/4/576.abstract\" target=\"_blank\">report \u003c/a>in the current issue of \u003cem>Health Affairs\u003c/em>.\u003c/p>\n\u003cp>That's a \"stunning number,\" says the study's lead author, Dr. Kenneth Mandl, at Harvard Medical School's Center for Biomedical Informatics.\u003c/p>\n\u003cp>Mandl and a colleague analyzed the insurance records of more than 700,000 women from 2011 to 2013. The women were between the ages of 40 and 59, and they all had routine mammograms to screen for breast cancer during that time period.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>About 11 percent of the women had \"suspicious\" mammograms and were subjected to further testing, including repeat mammograms, ultrasounds and needle biopsies. For nearly all these women — 98.6 percent — cancer was not confirmed in further testing.\u003c/p>\n\u003cp>When Mandl projects this percentage of false alarms to the entire female population over age 40, he estimates that the U.S. spends $2.8 billion each year on follow-up tests for suspicious results that turn out not to be cancer.\u003c/p>\n\u003cp>And even when cancer is detected, some of those tumors might be of low risk to the patient -- slow-growing and not likely to become invasive or life-threatening. But once suspicions are raised, Mandl says, overtreatment is often the result. \"Overtreatment is bad,\" he says. \"That's mastectomy, chemotherapy, radiation, in women who may not have needed any medical treatment at all.\"\u003c/p>\n\u003cp>For example, patients diagnosed with \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024042/\" target=\"_blank\">ductal carcinoma in situ\u003c/a> can face radiation, chemotherapy and even mastectomy despite the fact that the cancer is noninvasive.\u003c/p>\n\u003cp>Mandl estimates that the cost of overtreatment adds up to $1.2 billion each year, resulting in a grand total of $4 billion in unnecessary spending annually.\u003c/p>\n\u003cp>And it's not just the financial cost that's a problem. When a woman receives a suspicious mammogram result, it often creates psychological stress and anxiety, Mandl says.\u003c/p>\n\u003cp>Still, some researchers have issues with Mandl's findings. Dr. Richard Wender, of the American Cancer Society, says the study overestimates the cost of unnecessary testing and incorrect diagnoses. And he says it fails to consider the proven benefits of annual mammograms.\u003c/p>\n\u003cp>\"Mammograms are the most effective way we have to find breast cancer before anybody can feel it, before you're aware of it,\" Wender says.\u003c/p>\n\u003cp>He points to \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961611-0/abstract\" target=\"_blank\">studies\u003c/a> showing that mammograms reduce the risk of dying from breast cancer by 20 percent. \"So whenever we're doing decision-making, either as policymakers or just between one woman and her doctors, it's critical to look at ... benefits as well as downsides,\" he says.\u003c/p>\n\u003cp>The American Cancer Society\u003ca title=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\"> recommends yearly mammograms\u003c/a> for women starting at age 40. However, the U.S. Preventive Services Task Force \u003ca title=\"http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/breast-cancer-screening\" href=\"http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/breast-cancer-screening\" target=\"_blank\">recommends that screenings start later\u003c/a>, at age 50. That's because younger women, between 40 and 49, are more likely to receive false-positive results.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Harvard's Mandl would like to reduce the number of screening mammograms even further. He suggests that screening be based on a woman's overall risk factors for breast cancer, including family history, obesity and breast density, as well as age.\u003c/p>\n\n","blocks":[],"excerpt":"Overtreatment means mastectomy, chemotherapy, radiation, in women who may not have needed medical treatment at all.","status":"publish","parent":0,"modified":1429039882,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":596},"headData":{"title":"The Hidden Cost of Mammograms: More Testing and Overtreatment | KQED","description":"Overtreatment means mastectomy, chemotherapy, radiation, in women who may not have needed medical treatment at all.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"24926 http://blogs.kqed.org/stateofhealth/?p=24926","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/04/13/the-hidden-cost-of-mammograms-more-testing-and-overtreatment/","disqusTitle":"The Hidden Cost of Mammograms: More Testing and Overtreatment","path":"/stateofhealth/24926/the-hidden-cost-of-mammograms-more-testing-and-overtreatment","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24928\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000016019343_Large.jpg\">\u003cimg class=\"size-large wp-image-24928\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000016019343_Large-640x427.jpg\" alt=\"Instead of having mammograms according to age, some doctors think screening should be based on a woman's overall risk for breast cancer. (Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Instead of having mammograms according to age, some doctors think screening should be based on a woman's overall risk for breast cancer. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Patti Neighmond,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/04/13/398818949/the-hidden-cost-of-mammograms-more-testing-and-overtreatment\" href=\"http://www.npr.org/blogs/health/2015/04/13/398818949/the-hidden-cost-of-mammograms-more-testing-and-overtreatment\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>There's no question mammograms can save lives by detecting breast cancer early. But they can also result in unnecessary testing and treatment that can be alarming and costly.\u003c/p>\n\u003cp>In fact, each year the U.S. spends $4 billion on follow-up tests and treatments that result from inaccurate mammograms, scientists \u003ca href=\"http://content.healthaffairs.org/content/34/4/576.abstract\" target=\"_blank\">report \u003c/a>in the current issue of \u003cem>Health Affairs\u003c/em>.\u003c/p>\n\u003cp>That's a \"stunning number,\" says the study's lead author, Dr. Kenneth Mandl, at Harvard Medical School's Center for Biomedical Informatics.\u003c/p>\n\u003cp>Mandl and a colleague analyzed the insurance records of more than 700,000 women from 2011 to 2013. The women were between the ages of 40 and 59, and they all had routine mammograms to screen for breast cancer during that time period.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>About 11 percent of the women had \"suspicious\" mammograms and were subjected to further testing, including repeat mammograms, ultrasounds and needle biopsies. For nearly all these women — 98.6 percent — cancer was not confirmed in further testing.\u003c/p>\n\u003cp>When Mandl projects this percentage of false alarms to the entire female population over age 40, he estimates that the U.S. spends $2.8 billion each year on follow-up tests for suspicious results that turn out not to be cancer.\u003c/p>\n\u003cp>And even when cancer is detected, some of those tumors might be of low risk to the patient -- slow-growing and not likely to become invasive or life-threatening. But once suspicions are raised, Mandl says, overtreatment is often the result. \"Overtreatment is bad,\" he says. \"That's mastectomy, chemotherapy, radiation, in women who may not have needed any medical treatment at all.\"\u003c/p>\n\u003cp>For example, patients diagnosed with \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024042/\" target=\"_blank\">ductal carcinoma in situ\u003c/a> can face radiation, chemotherapy and even mastectomy despite the fact that the cancer is noninvasive.\u003c/p>\n\u003cp>Mandl estimates that the cost of overtreatment adds up to $1.2 billion each year, resulting in a grand total of $4 billion in unnecessary spending annually.\u003c/p>\n\u003cp>And it's not just the financial cost that's a problem. When a woman receives a suspicious mammogram result, it often creates psychological stress and anxiety, Mandl says.\u003c/p>\n\u003cp>Still, some researchers have issues with Mandl's findings. Dr. Richard Wender, of the American Cancer Society, says the study overestimates the cost of unnecessary testing and incorrect diagnoses. And he says it fails to consider the proven benefits of annual mammograms.\u003c/p>\n\u003cp>\"Mammograms are the most effective way we have to find breast cancer before anybody can feel it, before you're aware of it,\" Wender says.\u003c/p>\n\u003cp>He points to \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961611-0/abstract\" target=\"_blank\">studies\u003c/a> showing that mammograms reduce the risk of dying from breast cancer by 20 percent. \"So whenever we're doing decision-making, either as policymakers or just between one woman and her doctors, it's critical to look at ... benefits as well as downsides,\" he says.\u003c/p>\n\u003cp>The American Cancer Society\u003ca title=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\"> recommends yearly mammograms\u003c/a> for women starting at age 40. However, the U.S. Preventive Services Task Force \u003ca title=\"http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/breast-cancer-screening\" href=\"http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/breast-cancer-screening\" target=\"_blank\">recommends that screenings start later\u003c/a>, at age 50. That's because younger women, between 40 and 49, are more likely to receive false-positive results.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Harvard's Mandl would like to reduce the number of screening mammograms even further. He suggests that screening be based on a woman's overall risk factors for breast cancer, including family history, obesity and breast density, as well as age.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/24926/the-hidden-cost-of-mammograms-more-testing-and-overtreatment","authors":["8344"],"categories":["stateofhealth_13"],"tags":["stateofhealth_176","stateofhealth_461"],"featImg":"stateofhealth_24928","label":"stateofhealth"},"stateofhealth_23091":{"type":"posts","id":"stateofhealth_23091","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"23091","score":null,"sort":[1418930896000]},"guestAuthors":[],"slug":"see-what-happens-after-you-get-a-mammogram","title":"See What Happens After You Get A Mammogram","publishDate":1418930896,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_23092\" class=\"wp-caption aligncenter\" style=\"max-width: 520px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/m_jpg140030fa.png\">\u003cimg class=\"size-full wp-image-23092\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/m_jpg140030fa.png\" alt=\"(Courtesy: JAMA)\" width=\"520\" height=\"547\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/12/m_jpg140030fa.png 520w, https://ww2.kqed.org/app/uploads/sites/27/2014/12/m_jpg140030fa-400x421.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/12/m_jpg140030fa-320x337.png 320w\" sizes=\"(max-width: 520px) 100vw, 520px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Courtesy: JAMA)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2014/12/17/371463999/what-happens-after-you-get-that-mammogram\" href=\"http://www.npr.org/blogs/health/2014/12/17/371463999/what-happens-after-you-get-that-mammogram\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Women and their doctors have a hard time figuring out the pluses and minuses of screening mammograms for breast cancer. It doesn't help that there's been fierce dissent over the benefits of screening mammography for women under 50 and for older women.\u003c!--more-->\u003c/p>\n\u003cp>To make it easier to grasp the big picture, Dr. Jill Jin, an associate editor of JAMA, the journal of the American Medical Association, put together the above graphic on the odds of various outcomes from screening mammography. It's based on \u003ca title=\"http://jama.jamanetwork.com/article.aspx?articleid=1853165\" href=\"http://jama.jamanetwork.com/article.aspx?articleid=1853165\" target=\"_blank\">a review of studies\u003c/a> on the risks and benefits of mammography earlier this year and was \u003ca title=\"http://jama.jamanetwork.com/article.aspx?articleid=2040228\" href=\"http://jama.jamanetwork.com/article.aspx?articleid=2040228\" target=\"_blank\">published Wednesday\u003c/a> in JAMA.\u003c/p>\n\u003cp>Because mammograms aren't perfect screening tests, they can miss some cancers and falsely diagnose cancer that's not there. Those false positives can lead to more testing, including biopsies, and needless anxiety.\u003c/p>\n\u003cp>Mammograms can also lead to overdiagnosis, when a scan finds something that would never become life-threatening but can lead to surgery, radiation and chemotherapy. Some studies estimate that 20 percent of cancers found on mammograms are overdiagnosed and lead to unnecessary treatment, according to Jin.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The graphic looks at the odds of false positives, overdiagnoses and breast cancer diagnosis for 10,000 women over 10 years, if each started getting annual mammograms at \u003ca title=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\">age 50, the age recommended\u003c/a> by the U.S. Preventive Services Task Force. About 3,568 women will have normal exams, while 6,130 will have at least one false positive result. About 302 will be diagnosed with cancer, and 10 deaths will be averted because of screening.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Bottom line: Mammograms are the best tool we have for early detection of breast cancer, but they're not perfect. It's best to know the likelihood of possible harms, as well as the benefits.\u003c/p>\n\n","blocks":[],"excerpt":"Visualizing the odds you'll get a false positive -- or cancer detection -- when getting a mammogram.","status":"publish","parent":0,"modified":1419275421,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":9,"wordCount":304},"headData":{"title":"See What Happens After You Get A Mammogram | KQED","description":"Visualizing the odds you'll get a false positive -- or cancer detection -- when getting a mammogram.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"23091 http://blogs.kqed.org/stateofhealth/?p=23091","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/12/18/see-what-happens-after-you-get-a-mammogram/","disqusTitle":"See What Happens After You Get A Mammogram","path":"/stateofhealth/23091/see-what-happens-after-you-get-a-mammogram","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23092\" class=\"wp-caption aligncenter\" style=\"max-width: 520px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/m_jpg140030fa.png\">\u003cimg class=\"size-full wp-image-23092\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/m_jpg140030fa.png\" alt=\"(Courtesy: JAMA)\" width=\"520\" height=\"547\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/12/m_jpg140030fa.png 520w, https://ww2.kqed.org/app/uploads/sites/27/2014/12/m_jpg140030fa-400x421.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/12/m_jpg140030fa-320x337.png 320w\" sizes=\"(max-width: 520px) 100vw, 520px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Courtesy: JAMA)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Nancy Shute,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2014/12/17/371463999/what-happens-after-you-get-that-mammogram\" href=\"http://www.npr.org/blogs/health/2014/12/17/371463999/what-happens-after-you-get-that-mammogram\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>Women and their doctors have a hard time figuring out the pluses and minuses of screening mammograms for breast cancer. It doesn't help that there's been fierce dissent over the benefits of screening mammography for women under 50 and for older women.\u003c!--more-->\u003c/p>\n\u003cp>To make it easier to grasp the big picture, Dr. Jill Jin, an associate editor of JAMA, the journal of the American Medical Association, put together the above graphic on the odds of various outcomes from screening mammography. It's based on \u003ca title=\"http://jama.jamanetwork.com/article.aspx?articleid=1853165\" href=\"http://jama.jamanetwork.com/article.aspx?articleid=1853165\" target=\"_blank\">a review of studies\u003c/a> on the risks and benefits of mammography earlier this year and was \u003ca title=\"http://jama.jamanetwork.com/article.aspx?articleid=2040228\" href=\"http://jama.jamanetwork.com/article.aspx?articleid=2040228\" target=\"_blank\">published Wednesday\u003c/a> in JAMA.\u003c/p>\n\u003cp>Because mammograms aren't perfect screening tests, they can miss some cancers and falsely diagnose cancer that's not there. Those false positives can lead to more testing, including biopsies, and needless anxiety.\u003c/p>\n\u003cp>Mammograms can also lead to overdiagnosis, when a scan finds something that would never become life-threatening but can lead to surgery, radiation and chemotherapy. Some studies estimate that 20 percent of cancers found on mammograms are overdiagnosed and lead to unnecessary treatment, according to Jin.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The graphic looks at the odds of false positives, overdiagnoses and breast cancer diagnosis for 10,000 women over 10 years, if each started getting annual mammograms at \u003ca title=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm\" target=\"_blank\">age 50, the age recommended\u003c/a> by the U.S. Preventive Services Task Force. About 3,568 women will have normal exams, while 6,130 will have at least one false positive result. About 302 will be diagnosed with cancer, and 10 deaths will be averted because of screening.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Bottom line: Mammograms are the best tool we have for early detection of breast cancer, but they're not perfect. It's best to know the likelihood of possible harms, as well as the benefits.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/23091/see-what-happens-after-you-get-a-mammogram","authors":["8344"],"categories":["stateofhealth_13"],"tags":["stateofhealth_46","stateofhealth_176","stateofhealth_397"],"featImg":"stateofhealth_19209","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. 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