Dr Kenny Lin argues that unless the evidence changes, the guidelines shouldn't change, or net harms could result.
Associate Director, Family Medicine Residency Program, Lancaster General Hospital, Lancaster, Pennsylvania Hi, everyone. I'm Dr Kenny Lin. I am a family physician and associate director of the Lancaster General Hospital Family Medicine Residency , and I blog atat age 40. The bottom line is that when the evidence doesn't change, the guidelines shouldn't change.
These differences matter because women in their 40s, with the lowest incidence of breast cancer among those undergoing screening, have a lot of false positives. A patient who follows the USPSTF recommendation and starts screening at age 40 has awith every-other-year screening, or a 61% chance with annual screening, by the time she turns 50.
The recently implemented FDA rule requiring mammography reports to include breast density could compound this problem. Because younger women are more likely to have dense breasts, more of them will probably decide to have supplemental imaging for cancer. I I have personally cared for several patients who abandoned screening mammography for long stretches, or permanently, after having endured one or more benign biopsies prompted by a false-positive result. I vividly recall one woman in her 60s who was very reluctant to have screening tests in general, and mammography in particular, for that reason. After she had been my patient for a few years, I finally persuaded her to resume screening.
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.Patient Simulation: A 63-Year-Old Woman With Metastatic Breast Cancer
Breast Cancer Malignant Breast Neoplasm Breast Carcinoma Mammography Mammogram Breast Mammary Gland Cancer Malignant Neoplasia Carcinoma Malignant Neoplasm Cancer Risk Pennsylvania Biopsy Clinical Guidelines Guidelines Preventive Screening Screening Fellowship Fellows Anxiety Hospitals Psychosocial Residency Residents Ultrasonography Ultrasound Sonogram
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