Breast Center Imaging and Administrative Directors Voice Opinion on Mammography Recommendations
Several leaders at the Johns Hopkins Avon Foundation Breast Center have issued a statement regarding the new mammography screening guidelines suggested by the United States Preventive Task Force Service.
Leaders at the Breast Center also have sent the following Letter to the Editor to several media outlets.
To the Editor,
The US Preventive Services Task Force recommendations to cut screening entirely for women aged 40-49 and decrease it to every other year for women 50 and older has significant consequences.
National statistics show that about 18 percent of all breast cancers occur in women aged 40-49, and, at Johns Hopkins, more than one in four breast cancer patients are among this age group. We also know that breast cancers occurring in women under 50 tend to grow faster and more aggressively than in older women and arise in denser tissues, making their early detection more difficult.
Rather than doing no screening for women in their 40s, we maintain our recommendations for annual screening and advise younger women, who typically have denser breast tissue, to get digital mammography which improves the accuracy of detecting breast cancer in these women. We also recommend these women seek evaluations with dedicated breast imaging radiologists and encourage them to have clinical exams of their breasts.
For women 50 and older, the Task Force’s suggestion to decrease screening from annually to every two years will lead to more tumors found at a larger size and later stage, a likely precursor to higher death rates.
We also believe that the Task Force errs in casting aside self breast exam. Learning about the natural contours of the breast is an important part of maintaining breast health, and empowering women with this knowledge raises women’s awareness of the disease and the likelihood she will report a change to her physician. We still encounter many women in our breast cancer clinics whose first indication of a problem was after noticing a change in their breast.
In summary, we feel that cutting back on breast cancer screening could be damaging to women’s health, and a better course would be a commitment to improving screening methods and the accuracy of detection.
Nagi Khouri, M.D.
Associate Professor and Director of Breast Imaging
Johns Hopkins Avon Foundation Breast Center
Lillie Shockney, R.N., B.S., M.A.S.
University Distinguished Service Assistant Professor of Breast Cancer
Administrative Director of the Johns Hopkins Avon Foundation Breast Center