Battle over revamped Canadian breast cancer screening guidelines

TORONTO – The release this week of revamped Canadian breast cancer screening guidelines has set off a war of words.
    
On one side are those who support the recommendations and on the other are those who predict that following them will lead to more women dying of the disease.
    
The harshest criticism of the guidelines developed by the Canadian Task Force on Preventive Health Care is focused on its direction to average-risk women in their 40s.
    
The expert panel advises against routine mammography in this age group, saying that potential harms arising from the test trump the possible benefit of a small reduction in deaths.
    
Those harms include false-positive results requiring repeat tests, biopsies and in some worst-case scenarios, unnecessary mastectomies, radiation and chemotherapy.
   
A review of international clinical trial evidence, on which the guidelines are based, shows a third of women will have a false-positive.
    
But Dr. Nancy Wadden, chair of the mammography accreditation program for the Canadian Association of Radiologists, says the guidelines are based on studies done a generation ago, using outmoded mammography that is rarely used today.

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