As a radiologist, I’d like to respond to the recent controversial recommendations of the U.S. Preventive Services Task Force, modifying the guidelines for mammography.

The task force used flawed data, based on outcomes from older film mammography, in their conclusions. Nowadays, most experts recognize that digital mammography has shown a clear benefit in evaluating younger women with dense breasts, whose cancer may be harder to detect.

In their recommendations, the task force concedes that “digital mammography (is) better at detecting lesions in women who (are) younger than 50 years” old, yet they discount this because they feel the overall benefits of digital mammography have yet to be proven. The task force confuses the issue and dilutes their argument by recommending that women younger than 50 not get screened, even though digital mammography is the status quo at modern imaging centers, is widely available and is better.

The conclusions by this task force make a public policy statement, attempting to ration healthcare dollars based on flawed data. The assumption that screening mammography isn’t beneficial in patients under the age of 50 or over the age of 75 is disturbing.

The American Cancer Society reports 17 percent of breast cancer deaths in 2006 were among women who were diagnosed between the ages of 40 and 49. This isn’t a trivial number (6,800 women a year!) The task force also concluded that screening women over the age of 75 wasn’t cost effective as more than likely these women would die of other medical conditions rather than breast cancer.

This conclusion unfortunately resembles some politicians’ claims of death panels and the rationing of healthcare. Who are we to judge the value of life, at any age?

However, the recommendation to limit screening mammograms based upon population-based cost-analysis is frightening, as it fails to take the individual patient risk factors into account.

We’re finding about 20 percent of our yearly cancers in the 40 to 49 age group, the same group the task force is recommending not to have mammograms.

I’d hate to see our community develop a higher breast cancer mortality rate due to rationing healthcare dollars!
Robert A. Princenthal, MD,
director of women’s imaging,
Rolling Oaks Radiology Medi
cal Group
Thousand Oaks