The American Cancer Society updated breast cancer screening guidelines Tuesday to reduce mammograms and do away with clinical breast exams — but some predict it will be difficult to get physicians to follow these new guidelines.
The new update recommends women at average risk of developing breast cancer start regular annual mammograms at age 45 and move to screening every two years at age 55 until they have less than 10 years left to live. These new guidelines were adopted to reduce false positives from over-screening.
However, as coverage in The New York Times notes, the new guidelines mark a significant change from old recommendations to start annual mammograms at age 40 and clinical breast exams at 20.
Though these changes are backed by studies that show screening too early and frequently can result in many false positives, it will be difficult to get physicians to adhere to the new, more lenient guidelines, according to the report.
"It is very hard to get doctors to do less," Aaron Carroll, MD, New York Times contributor and professor of pediatrics at Indianapolis-based Indiana University School of Medicine, wrote. He notes a pair of studies that show how difficult it is for physicians to be less aggressive after they have been trained to the opposite. One study showed efforts to lessen C-sections in 32 Quebec hospitals resulted in a 0.7 percent reduction over a year and a half. The other showed tight glycemic control, which was previously preferred for elderly patients, has actually increased since the practice was determined harmful in 2008, according to the report.
For breast cancer in particular, Mr. Carroll notes, it will be difficult to move to less aggressive screening and treatment. More than two-thirds of women who have prophylactic mastectomies don't have the mutation that requires the procedure — and the procedure does not improve survival, according to the report.
"For decades, we've been told, over and over, that more screening is better, that early detection is the key to a cure. That's true, up to a point. We seem to have passed that point, though, and more and more experts are trying to reverse course," Mr. Carroll wrote.
Read the full report here.
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