Survey: Most surgeons disregard USPSTF recommendations for breast cancer screening

More than 85 percent of surgeons—including breast specialists and general surgeons—continue to follow breast cancer screening recommendations more closely aligned with those of the American Cancer Society, the American College of Radiology (ACR) and the Society of Breast Imaging, rather than those issued by the U.S. Preventive Services Task Force (USPSTF), according to a study presented April 21 at the ARRS 2015 Annual Meeting in Toronto.

Vilert Loving, MD, director of breast imaging at the Banner MD Anderson Cancer Center in Gilbert, Ariz., and colleagues from the NYU Cancer Institute and the VA San Diego Healthcare System, based their findings on the results of an Internet-based survey of 288 surgeons. The researchers said most respondents tended to disregard screening guidelines issued by the USPSTF, which recommends routine biennial screening for women aged 50-74 years only. In fact, 88 percent of breast surgeons and 82 percent of general surgeons rely instead on recommendations that call for annual screenings for women with an average risk of cancer beginning at age 40. Asked when they would prefer to begin breast cancer screening for themselves, 93 percent responded that they would initiate annual screenings by age 40 as well.

"[T]he public should know that the physicians who diagnose and treat women with breast cancer still believe in annual mammography starting at age 40 for average-risk women,” said the researchers in a public statement.

The USPSTF released an update to their 2009 breast cancer recommendations earlier this week, which reaffirmed their recommendations for biennial screenings of women aged 50-74 years old, while adding the caveat that women with an exceptional risk of cancer due to family history or other factors may benefit from screening at age 40. The USPSTF argued in the update that beginning annual screenings earlier could result in excessive overdiagnosis, unnecessary biopsies and increased rates of false-positive findings.

The recently updated recommendations were once again denounced by many in the radiology and oncology communities, including the ACR, who said that following USPSTF recommendations would result in the additional deaths of thousands of women from missed or undiagnosed breast cancers.