What were main take-home messages of new ACS mammography guidelines?

The Journal of the American Medical Association published “Breast Cancer Screening for Women at Average Risk2015 Guideline Update From the American Cancer Society.”  The recommendations: 

The ACS recommends that women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 years (strong recommendation). Women aged 45 to 54 years should be screened annually (qualified recommendation). Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually (qualified recommendation). Women should have the opportunity to begin annual screening between the ages of 40 and 44 years (qualified recommendation). Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer (qualified recommendation). The ACS does not recommend clinical breast examination for breast cancer screening among average-risk women at any age (qualified recommendation).

The journal’s Patient Page emphasized what was new and different, including this graphic.

JAMA Patient Page - mammography

The CBS Evening News emphasized that the ACS “now says that women should get their first mammogram years later than previously recommended.”

NBC Nightly News focused on this:  “Instead of age 40,” the ACS now “recommends women start at age 45 if they are of average risk, without genetic mutations or a family history of breast cancer. At 55, women should transition to screening every other year if they have a life expectancy of ten years or longer.” The story noted that the ACS “said the changes are designed to eliminate false positives and over treatment.”

ABC World News stressed that the ACS is “also dropping its previous recommendation that women have a manual exam so doctors can feel for abnormalities, because it’s never been shown to save lives.”  Online, ABC called it a “major shift.”

USA Today reports that these guidelines “reflect the growing recognition that mammograms can do harm, as well as good, said Richard Wender, chief cancer control officer at the” ACS.

The New York Times headline was “Big news on the shifting recommendations for mammogram frequency from the American Cancer Society.” It reported that “although the new guidelines may seem to differ markedly from the old ones, the American Cancer Society carefully tempered its language to leave plenty of room for women’s preferences.”

The Washington Post headlined it, “In major shift, new guidelines scale back breast cancer screenings for younger women.”

The Wall Street Journal’s headline: “New guidelines push back age for mammograms.”

That’s how some leading news organizations told the story.

But you might never know what the big news was if you only read a Mayo Clinic news release which had an entirely different emphasis. It led with this:

The recommendations strongly support the value of mammograms and provide some further direction for women at both ends of the age spectrum.

“That was probably the most important take-home message,” says Sandhya Pruthi, M.D., a Breast Clinic physician and Mayo Clinic Cancer Center researcher. “The benefit of mammography has been shown to reduce death from breast cancer and women who are screened do get that benefit.”

Really?  That was the biggest take-home? Are we all reading the same report?  The Mayo news release never explained what the clear new emphasis of the American Cancer Society recommendation was.  Puzzling.

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