The new breast cancer screening guidelines announced November 16th by the U.S Preventive Services Task Force have sparked widespread anger and confusion. The debate centers on the relative risks and benefits of various methods of trying to pick up breast cancer at an early stage. All current techniques, including mammography, MRI, ultrasound, and breast exam, can reveal abnormalities that end up being benign. These so-called “false positives” often lead to expensive, anxiety-producing, and invasive testing such as biopsy and fine-needle aspiration. The big question is: What screening tests are “worth it” and how do we define “worth it?”
I asked two experts on the front lines of patient care to join me in a live webcast to provide some perspective. Dr. Freya Schnabel, Director of Breast Surgery, NYU Langone Medical Center and Professor of Surgery at NYU School of Medicine and Dr. David Dershaw, Director of Breast Imaging at Memorial Sloan-Kettering Cancer Center helped answer the most common questions of our CBS News viewers, including:
1. What are the new recommendations?
2. Do they apply to “high risk” women, such as those who have a close family member with breast cancer?
3. How many women between ages 40 and 50 get breast cancer every year?
4. Do mammograms save lives? How many women have to be screened with mammography to prevent one death?
5. What percentage of abnormal findings on mammography turn out to be benign and are therefore “false positives?”
6. Will these new guidelines give insurance companies an excuse to ration care? What are Medicare and the insurance industry saying about their plans to pay for mammography?
7. Should women examine their breasts for abnormalities?
8. How high is the risk of cancer from radiation exposure during mammography?
9. What role do other imaging techniques such as ultrasound and MRI have in breast cancer screening?
10. Bottom line: What should women do – especially those who are ages 40 to 49? How should a woman and her physician think about the relative risks and benefits of breast cancer screening?