ACS alters screening recommendations in light of new research, technology

ACS alters screening recommendations in light of new research, technology

The American Cancer Society (ACS) announced that it was adjusting its recommendations for breast cancer screenings. It now advises women to begin annual screenings at 45 years of age, rather than 40.

The American Cancer Society (ACS) announced that it was adjusting its recommendations for breast cancer screenings. It now advises women to begin annual screenings at 45 years of age, rather than 40.

In addition, the ACS now suggests that women over 55 get screened every other year. If woman under 45 years old or over 55 years old wish for additional screenings, they are encouraged to talk to their healthcare provider. Finally, the ACS no longer recommends breast exams- either self-exams or those given by a doctor. The ACS stresses that its guidelines are geared towards women with an average risk of breast cancer. Women at higher risk should consult with their doctor.

Published in the Journal of American Medical Association, the latest suggestions reflect new research into the breast cancer prevention and the best methods for screening.

“Since we last wrote a breast cancer screening guideline, there have been the publication of quite a number of new studies that inform us about the benefits and drawbacks of screening with mammography, so the American Cancer Society commissioned a detailed evidence review by an external expert group to review all of this new data which was then presented to our American Cancer Society guideline committee,” said Dr.Richard C. Wender, American Cancer Society’s chief cancer control officer.

“That committee then considered all of this evidence over a period of months, did the very difficult job of balancing the benefits and harms, and that’s what led to the change in the guidelines that we’re publishing now.”

Breast cancer is the second leading cause of cancer-related deaths in women. It is the most common cancer currently afflicting women. Millions of dollars are donated to the Pink cause every year and science has been making great progress is treatment and prevention.

“Ideally any good screening test should find early disease such that better treatment options and outcomes are available to the patient. Recognizing the limitations of mammography, screening mammography is the only test proven to do this for breast cancer,” said Dr. Brandi Nicholson, medical director of breast imaging for the University of Virginia Health System and UVa Culpeper Hospital. “Tomosynthesis, or 3-D mammography, has been shown to be 30 percent more sensitive and 30 percent more specific. Tomosynthesis is a big improvement to 2D mammography and will benefit women. We also have ultrasound which can be used in average or moderate risk women with increased breast density in addition to mammography to improve cancer detection. Along with these resources, having well-qualified breast radiologists interpret screening mammograms improves cancer detection and false positive rates.”

Regular screenings for is one of the most effective ways to save lives from the cancer. If the tumor can be spotted early on, it can be removed with less difficulty.

There has been some backlash after the new recommendations were announced on October 20. Some medical professionals insist that screen women 40 years old or even younger is the best practice. The ACS in no way discourages or forbids this. Rather, in an effort to limit false positives and unnecessary tests, it suggests that women without family histories of cancer, without breast complications, and without any other factors that may increase their risk of cancer, these women do not necessarily need to be screened as much.

“The challenge for doctors who order screening mammograms is to stratify who is truly average risk and who is not. For patients who are not clearly average risk, screening mammography should still start before 45 and should be personalized for each patient’s unique risk level,” said Dr. Syed Salman Ali, a Fauquier Health oncology/hematology physician. “Overall, the ACS guidelines do a good job of balancing evidence from large population based studies, and the individualized needs of each patient. The real take home point from all of this is that careful risk assessment for each patient is an essential part of cancer prevention.”

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