Medical societies say that new breast cancer screening guidelines by the American College of Physicians (ACP) will cause continued confusion among women.
The American College of Radiology (ACR) and the Society of Breast Imaging (SBI) issued a joint statement on April 17, saying that the new guidelines, which call for biennial screening for women ages 50 to 74, will add more hardships for women.
“Thousands more women would endure extensive surgery, mastectomies, and chemotherapy for advanced cancers than if their cancers were found early by an annual mammogram,” the ACR and SBI said.
The ACP on April 17 issued its latest guidelines on breast cancer screening. Along with the biennial screening guideline, the college also said women ages 40 to 49 should engage in informed decision making with their physicians about their breast cancer risk.
The guidelines also say that supplemental DBT should be considered in women with BI-RADS density category C or D, and that clinicians should not use supplemental MRI or ultrasound in asymptomatic women with average risk and with dense breasts (BI-RADS C or D).
The ACR and SBI recommend that women begin annual screening at age 40. The ACR also recommends that women have a risk assessment by age 25. Additionally, women at higher risk for breast cancer should talk to their doctor about beginning screening before age 40, the ACR stated.
The joint statement said the ACP guidelines “conflict with guidelines from nearly every other national society – especially those with cancer expertise.”
“ACR and SBI respect ACP efforts to advocate for our shared patients across many medical conditions and indications but ask ACP to defer to breast cancer diagnosis and treatment experts regarding this matter,” according to the joint statement.
The ACP guidelines may result in up to 10,000 more breast cancer deaths in the U.S. each year, the ACR and SBI said.
The two imaging societies added that the DBT recommendation for women with dense breasts is “out of step” with current research, and that women over age 74 still benefit from regular screening.
“Women over age 74 often choose to have treatment when diagnosed with breast cancer,” they added.
The ACR and SBI said screening risks are overstated, saying that faulty assumptions, methodology, and hyperbole in articles lead to such claims.
“High overdiagnosis claims are not well-founded. Such claims based on modeling studies are inflated,” they said. “Well-designed studies provide an overall breast cancer overdiagnosis estimate of 10% or less. Screening-detected breast cancers do not disappear or regress if left untreated.”
Finally, the two societies said false-positive exams are “usually resolved” by women coming back for more imaging via mammography, ultrasound, or MRI.
“Anxiety from an inconclusive mammogram result or false positive is brief with no lasting health effects,” they said. “Nearly all women who have had a false-positive exam still endorse regular screening.”
Read the full statement here.
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