AUDIE CORNISH, HOST:
There are new mammogram guidelines out today. They say women between the ages of 40 and 50 who are considered to be at average risk for breast cancer may opt to hold off on routine screenings. The guidance comes from the American College of Obstetricians and Gynecologists. Barbara Levy is the group's vice president of health policy. She joined us to explain the change.
BARBARA LEVY: For women at average risk, we are recommending that there is a conversation and shared decision-making starting at age 40. And that between ages 40 and 50 women may choose not to be screened, they may choose to be screened every year or every two years based upon her values and how she looks at the literature and the data that we have so far. Beginning at age 50, we are recommending every one- to two-year mammograms until at least age 75.
CORNISH: So it sounds like the shift is that at age 40 you're offering a little more flexibility. Before you were essentially saying, please do this.
LEVY: That's exactly right. What we're saying is that there are more cancers in women as women get older. And so the balance of risks and benefits is clearly in favor of screening beginning at 50. Beginning at 40, we have a lot more false positives, a lot more callbacks, a lot more biopsies that don't turn into anything. And so that value assessment of how likely is the screening to show something that will impact my life is much more problematic between 40 and 50.
CORNISH: So what if you yourself finds a lump and you're in your 40s, you're of average risk?
LEVY: If you feel a lump in your breast, you must go see a provider and have that assessed whether you had a normal mammogram a month ago or not.
CORNISH: So for a lot of people listening, and I know for me - I feel like I can't keep up with breast screening guidelines. Can you help us understand what prompted this update?
LEVY: Yes. I mean, women are confused and doctors are confused. There are so many different things out there. And what we've tried to do is pull that all together into something that says breast cancer isn't one disease. We used to think of it as cancer is cancer. But now we know that there are very, very slow growing cancers that might never kill somebody and there are very rapidly growing cancers that will come up in between screening. And that's not something we can screen for. So it's really time to sit down with our patients and help our patients understand all of that complexity and make choices that are the best for her and her own values.
CORNISH: So given that, what's your response to people who look at the guidelines and will argue that annual mammograms save lives and that cutting back on them could be a problem?
LEVY: So the issue is how many women will we treat for a cancer that will never actually turn into anything? How many women will we subject to biopsies, to chemotherapy, to radiation who would never have needed it versus how many women might die? And those are statistics based on populations. And the reality is that breast cancer's a very personal thing. It happens to individuals. And so the issue about screening is the guidelines are based on population data, not based on what an individual woman might face.
CORNISH: Is this a moment that feels to you like some kind of consensus - right? - in the medical community about what women should do about mammograms?
LEVY: So I think we're coming to a consensus that says that the data are messy, studies are not perfect, and the answers are not black and white. But the consensus is here are the information pieces that you can use to make a value judgment for yourself.
CORNISH: Dr. Barbara Levy is vice president of health policy for the American College of Obstetricians and Gynecologists. They issued new breast cancer screening guidelines today. Thank you for speaking with us.
LEVY: My pleasure.
(SOUNDBITE OF KISHI BASHI SONG, "CAN'T LET GO, JUNO")
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