Talking Points:

• The RSNA claims independent guidelines by the US Preventative Services Task Force discourage women from being screened.

• The RSNA has an interest in promoting its own procedures as a preventative means despite the fact that many women screened often have false positive diagnosis and over-treatment.

CHICAGO: Breast cancer screenings are again in the news as the Radiological Society of North America (RSNA, meeting in Chicago this week) claims that the guidelines set forth by the U.S. Preventive Services Task Force — an independent medical panel with federal support–could discourage some women from being screened. The Radiological Society obviously has an interest (some might say conflict of interest) in promoting its own procedures that sometimes cause false-positive cancer diagnosis and over-treatment.

The RSNA looked at rates of mammograms from women 65yrs and older on Medicare. The rates of screenings inched up 1% between 2005 and 2009, but dropped as soon as the U.S. Preventative Services Task Force released their recommendation.

The claim that increased screening leads to decreased mortality is both confusing and controversial simply because there are many cases of screenings which result in early detection and misdiagnosis. They catch cancer that has to be biopsied and in many cases turns out to be malignant, but this doesn’t take into account the fact that no one knows which cancers will be fatal or not.

The problem, the panel said, is that for women younger than 50, the benefits of mammograms may not outweigh the risks. Those include “false-positive” results that lead to needless invasive tests and anxiety (which are more common in women younger than 50), and over-treatment of early breast tumors that would never have progressed.