Dr. Cappello's Blog Post: USPSTF Draft Guidelines Get a D for being Dense
April 20, 2015: U.S. Preventive Services Screening Task Force (USPSTF) issues draft of new breast screening guidelines with these conclusions: For women at average breast cancer risk, most of mammography's benefits will come from biennial screening between the ages of 50 to 74 years, with the highest benefit going to women ages 60 to 69. Public comments end May 18, 2015.
Dense Breast Tissue received an IGrade: The current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasound, magnetic resonance imaging (MRI), tomosynthesis, or other modalities in women identified to have dense breasts on an otherwise negative screening mammogram.
The Gray Sheet interviewed Dr. Cappello about the Task Force's Inconclusive Recommendation about adjunct screening for women with dense breast tissue. They reported that Are You Dense Inc. is leading the effort for state and national requirements for dense-breast reporting.
"Every consumer has a right to know about the risks and benefits of screening mammography and adjunct tests for breast cancer detection,” Nancy M. Cappello, Ph.D. director and founder of the group, told “The Gray Sheet.”
Despite USPSTF's conclusion of insufficient evidence, “What remains conclusive in the USPSTF report is that mammography is limited in dense breasts and added screening finds invasive cancers invisible by mammography," Cappello said. "Invasive cancers are not just a nuisance – they can kill. At any age, women need to know about their risks and at the same time the benefits and harms of screening, including secondary screening, to make informed decisions with health care providers without any fear of economic barriers,” she added.
Highlights:
- Of all age groups, women ages 60 to 69 years are most likely to avoid a breast cancer death through mammography screening.
- Screening mammography in women ages 40 to 49 years may reduce the risk of dying of breast cancer, but the number of deaths averted is much smaller than in older women and the number of false-positive tests and unnecessary biopsies are larger.
- All women undergoing regular screening mammography are at risk for the diagnosis and treatment of noninvasive and invasive breast cancer that would otherwise not have become a threat to her health, or even apparent, during her lifetime (known as “overdiagnosis”). This risk is predicted to be increased when beginning regular mammography before age 50 years.
- Women with a parent, sibling, or child with breast cancer may benefit more than average-risk women from beginning screening between the ages of 40 and 49 years.
- The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women age 75 years and older.
- The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of tomosynthesis (3-D mammography) as a screening modality for breast cancer.
Access Full Report HERE.