Mammograms

A government panel's recommendation Monday that women under the age of 50 do not need regular mammograms set off a furious debate about the importance of the routine screening tool, leaving many women confused about how best to protect their health. In issuing its guidelines, the U.S. Preventive Services Task Force concluded that risk of breast cancer is very low in women age 40 to 50 and that the risk of false positives and complications from biopsies and other invasive procedures is too high for the procedure to be used routinely.

Are you due for a cancer screening test? Don't let cost stand in the way. Yes, it would be easier to schedule such tests if you have insurance, a regular doctor who can refer you to screenings and money in your checking account to foot the bill. But with some digging, you can often find free or low-cost cancer detection tests that could just save your life. A study published in June in CA: A Cancer Journal for Clinicians found that about 650,000 deaths from cancer were avoided or delayed between 1990 and 2005.

For years, breast cancer awareness campaigns have urged women over 40 to get a yearly mammogram. When women hesitate to comply, it's often to avoid the discomfort of having their breasts squeezed or the fear of getting called back for more tests, even if it turns out there's no cancer. But screening poses another downside: A routine mammogram can find cancers that would never have become life-threatening, subjecting women to painful and toxic treatments they never actually needed.

Requiring even a small co-payment dramatically reduces the likelihood that women will get regular mammograms to detect breast cancer. Screening rates from 2001 through 2004 were nearly 11% lower for women who had to contribute a co-pay as low as $12, compared with women whose breast X-rays were free, researchers from Brown and Harvard universities report in the Jan. 24 issue of the New England Journal of Medicine. They surveyed more than 366,000 women ages 65 to 69. "I think it's a surprising result," said Dr. Amal Trivedi of Brown, who led the study.

Patient treatment records from a large HMO show that the recent decline in breast cancer rates is linked to a sharp drop in use of hormone replacement therapy and not to reductions in the percentage of women getting mammograms, as many scientists had speculated, researchers said Tuesday. Dr. Andrew G. Glass and his colleagues at Kaiser Permanente Northwest in Portland, Ore.

After rising steadily for decades, the proportion of U.S. women getting mammograms to screen for breast cancer has dropped, federal researchers report in a study published online today. The share of women older than 40 undergoing regular mammograms fell 4 percentage points from 2000 to 2005, the first significant decline since use of the breast X-rays started rapidly expanding in 1987, the study by the National Cancer Institute and Centers for Disease Control and Prevention found.

An increasingly popular technology that uses computers to scan mammograms actually produces worse results than human reviewers using their eyes and experience, according to a study released Wednesday. Radiologists using computer-assisted detection software were more likely to interpret a benign growth as potentially cancerous, researchers said in the New England Journal of Medicine.

Elizabeth Edwards said Wednesday that she felt she had let down her family and the country by neglecting to get mammograms that could have caught her cancer earlier. Edwards -- appearing with her husband, Democratic presidential hopeful John Edwards, in their first trip to Iowa since announcing her cancer had returned -- admonished women to get mammograms.

The nation's largest medical specialty group is challenging the widely accepted recommendation that women should routinely undergo mammograms in their 40s, saying the risks of the breast exams may outweigh the benefit for many women. The American College of Physicians, which represents 120,000 internists, plans to issue new guidelines today that instead urge women in their 40s to consult with their doctors individually about whether to get the breast X-rays.

In women newly diagnosed with cancer in one breast, an MRI can find the disease in the opposite breast more effectively than standard mammography or clinical examination, scientists said Tuesday. MRI, which stands for magnetic resonance imaging, detected cancers that had been missed by the other methods in 3.1% of patients in a large clinical study, researchers said.