publication date: Apr. 24, 2015

Four Decades of Mammography Wars


The latest draft guideline by the U.S. Preventive Services Task Force is part of nearly a four-decade war over the appropriateness of screening women between the ages of 40 and 49.

In this war, Congress usually intervened, claiming that “common sense” dictates that mammography is efficacious in younger women. This war has often engulfed NCI.

This timeline appeared in part in the Nov. 20, 2009, issue of The Cancer Letter.

In May 1977, NCI first adopts guidelines for mammography for use in breast cancer screening (The Cancer Letter, May 13, 1977). This was not a guideline for all women, just those women under 50 who were participating in the NCI-American Cancer Society study called the Breast Cancer Detection Demonstration Project. Younger women in the study were to receive screening only if they had a previous history of breast cancer or a mother or sister with the disease.

Later that year, the very first NIH Consensus Development Conference examined the issue of screening mammography and whether to continue the BCDDP. The panel concluded, based on data from the study, that screening mammography should be available for women over 50. Women 40-49 with a personal history of breast cancer or whose mothers or sisters had breast cancer should continue to be screened within the study (The Cancer Letter, Sept. 23, 1977).

In 1987, the results of the BCDDP came in. Though it was not a randomized trial, the results seemed to infer that younger women would benefit from … Continue reading 41-16 Four Decades of Mammography Wars

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