Breast cancer screening guidelines revised in Canada

Reality: Survival rates are about the same for women who have mastectomies and for women who choose the breast-conserving option of removing only part of the breast and following the surgery with radiation treatments. However, there are some cases - such as with extensive DCIS disease, the presence of BRCA gene mutations, or particularly large tumors - when lumpectomy and radiation may not be an appropriate treatment option. More from Health.com: How to help a loved one cope with breast cancer istockphoto

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(CBS) Is breast cancer screening a bust for women in their forties?

PICTURES: Busted! 8 mammogram truths every woman must know

New guidelines from a Canadian task force call for an end to routine mammography screening for women between the ages of 40 and 49. The task force says the small risk for breast cancer among these women is outweighed by the risk for overdiagnosis and overtreatment. 

"There was no evidence that screening with mammography reduces the risk of all-cause mortality," the authors concluded in a written statement.

The Canadian Task Force on Preventive Health Care report also said that women between the ages of 50 and 74 should get screening mammograms every two to three years. Screening every other year has been standard practice in Canada.

The guidelines outlined in the report - published in the Canadian Medical Association Journal - also call for an end to breast self-exams and doctor-administered breast exams in the absence of symptoms of breast cancer.

The guidelines were last updated in 2001.

The revised guidelines come in the wake of ongoing debate in the U.S. over similar breast cancer screening guidelines issued by the U.S. Preventive Services Task Force in 2009. Some argue that less-frequent mammography means women will die needlessly of breast cancer, while others say less-frequent screening helps cut back on false-positive diagnoses and the needless anxiety and medical care they lead to.

Recent research has failed to settle the debate, with some studies showing that women in their forties benefit significantly from mammography screening and other studies showing only a trivial benefit, Medpage Today reported.

Think the revised guidelines go too far in downplaying the value of mammograms? A Danish doctor who wrote an editorial accompanying the report seems to think the revised guidelines don't go far enough.

"The best method we have to reduce the risk of breast cancer is to stop the screening program," Dr. Peter Gotzsche of the Nordic Cochrane Center in Copenhagen, said in the statement. "This could reduce the risk by one-third in the screening age group, as the level of overdiagnosis in countries with organized screening programs is about 50 percent."

For now, the American Cancer Society recommends annual mammograms starting at age 40.

The National Cancer Institute has more on mammography.

  • David W Freeman

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