Breast Imaging

The U.S. Preventive Service Task Force (USPSTF) recently revised their mammography guidelines, stating that women can wait until age 50 to have biennial (every 2 years) screening mammograms. However, research presented at the annual meeting of the American Society of Breast Surgeons indicated that following the USPSTF guidelines would actually have a negative impact on survival. And we agree.

Over the last few weeks, there has been a lot of discussion in the news media about thyroid cancer and increased radiation risks to women – specifically about how the use of thyroid shields during mammograms may or may not be useful in protecting against excess radiation exposure.

A study published in the April 2011 issue of Radiology found that by increasing the experience requirement for readers of mammograms in the U.S., the number of false-positives would decrease, along with the amount of money spent on mammography each year.

As the co-author of a recent study published in the Journal of the American Medical Association, I want to emphasize one of the conclusions of the study, which was buried in recent news reports.

A recent Florida study, as reported in The New York Times, concluded that three times the number of surgical breast biopsies are being performed than medical guidelines call for. The authors of that study are of the opinion that three times the number of women are having unnecessary surgery, and the associated costs are in the hundreds of millions of dollars a year. That may be the experience in Florida, where the research was performed, but the common practice at UCSF is dramatically different.

An article in the February issue of the American Journal of Roentgenology provides further support for the benefits of screening mammography starting at age 40. The Women’s Imaging Section at UCSF continues to support the American Cancer Society guidelines of annual mammography screening starting at age 40.