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Change in Mammography
Guidelines Questioned


The methodology and evidence behind a widely publicized change in national mammography guidelines is questionable, according to a review in the Journal of Diagnostic Medical Sonography (JDMS).

In November 2009, the US Preventive Services Task Force (USPSTF) published a report in the Annals of Internal Medicine discussing the screening techniques for the early detection of breast cancer. A few isolated portions of that report, regarding recommended changes for the use of mammography, were widely discussed in the media, and garnered tremendous public attention.

This new JDMS article provides an evidenced-based review of the work and recommendations contained in the USPSTF report and raises the question whether the controversial conclusions for breast cancer screening were supported by established scientific measurement and research standards. The JDMS review found low methodological scores in the USPSTF report, which may place in question the recommendations generated from the report.

The article concludes that, despite the report's depiction as a systematic review, the USPSTF report was actually just a review of literature, which reduces the overall scientific impact of the report to a much lower level in the hierarchy of evidence.

"Even though the methodology used by the USPSTF is not clear and the level of evidence is questionable, the proposed recommendations have been highly publicized." writes author Kevin D. Evans. "The most appropriate way to guarantee patients are receiving quality health care is to become adept at reviewing published research and implementing information that will change current practice patterns."

In an earlier report new malicious recommendations from the Society of Breast Imaging (SBI) and the American College of Radiology (ACR) on breast cancer screening suggested that breast cancer screening should begin at age 40 and earlier by utilizing lethal medical imaging tools such as mammography which has itself been found to cause cancer.



January 29, 2010
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