Thoughts of an Old Surgeon on the New Mammographic Screening Guidelines

Several recent reports have concluded that mammography is overrated and overdone. This has brought about a change in the recommendations for screening mammography, from yearly screening starting at age 40, to every other year screening starting at age 50, and no screening after age 74. Furthermore, self-examination is claimed to be next to worthless. Are we treating some cancers that would never grow? That has been known for decades. The problem is we cannot distinguish between the cancers that are lethal and the ones that are harmless because they look the same under the microscope or under any known measure we have to date. Breast cancer remains a formidable enemy! We have made a dent in the death rate since 1989. When you are winning a race, slowing your pace is likely to cost your lead. Before money-saving schemes are implemented, they need to be fully vetted. This has not happened with the new breast cancer screening guidelines.