NEW YORK: A new paper by an Indian American researcher at Johns Hopkins Medicine in Baltimore, Dr. Archana Radhakrishnan, that involved data on 871 primary care physicians and gynecologists in the United States who self-reported their breast cancer screening practices, reveal that many physicians and gynecologists still recommended mammography screening for women ages 40 to 44, last year.
The paper was published in the journal JAMA Internal Medicine on Monday.
The new findings go against the recommendations of experts who are divided on the issue. The American Congress of Obstetricians and Gynecologists recommends annual mammograms starting at 40 for all women, whereas the US Preventive Services Task Force recommends biennial mammograms starting at 50 for all women.
In 2015, the American Cancer Society updated its guidelines to recommend that women with an average risk of breast cancer have the option to start screening with a mammogram every year starting at age 40, and should undergo regular mammogram screenings starting at age 45.
About 12% of women born in the United States will develop breast cancer at some time during their lives, according to the National Cancer Institute.
The new paper on 871 primary care physicians and gynecologists in the United States, self-reported their breast cancer screening practices in a mailed survey from May to September 2016.
The data came from the Breast Cancer Social Networks national survey, which included physicians who were randomly sampled from the American Medical Association’s physician masterfile.
Overall, 81% of physicians who completed the survey recommended screening for women 40 to 44; 88% for women 45 to 49; and 67% for women 75 and older, reported CNN.
“Our results serve as a benchmark for breast cancer screening recommendations as guidelines continue to evolve,” said Radhakrishnan, lead author of the new paper. “Despite changes to guidelines, doctors are continuing to recommend routine mammograms to both younger and older women,” she said. “The recommendations varied depending on physician specialty; gynecologists were the most likely to recommend screening.”
Among the physicians in the paper who recommended screening, 62.9% recommended annual examinations for women 40 to 44, 66.7% for women 45 to 49 and 52.3% for women 75 and older.
Dr. Mitva Patel said that she not only recommends annual screenings for women 40 and older, she follows those guidelines herself, reported CNN.
“I am 42. I have had my annual mammogram at age 40, 41 and 42,” said Patel, a breast radiologist at the Ohio State University Comprehensive Cancer Center, who was not involved in the paper. She added that the American College of Radiology and the Society of Breast Imaging both recommend yearly screenings for women 40 and older.
“I put myself in patients’ shoes when I make a recommendation as a doctor, and I say, ‘this is what I would do for myself,’ Patel said. “There are so many different recommendations, and it can be confusing. So it’s important for patients to make their decision for screening with their primary care physician, and I’m encouraged that this study shows most primary care physicians still believe in annual screening starting at age 40.”
Neither the American Cancer Society nor the US Preventive Services Task Force recommend routine mammograms for women 40 to 44 because they are more likely to offer downsides than benefits, according to an editorial published alongside the new paper in the journal JAMA Internal Medicine.
“From my experience, working with patients, most say that they want to catch the cancer early. They’d rather find out,” said Patel, the breast radiologist.
Although most breast cancers are found in women 50 and older, about 11% of all new cases of breast cancer in the US are found in women 45 and younger, according to the Centers for Disease Control and Prevention.
“These women who are diagnosed in their 40s, their cancer can be more aggressive,” Patel said.