ARRS: Most surgeons disregard USPSTF breast guidelines

Most surgeons continue to recommend that average-risk women older than 40 receive annual mammography screening, despite the 2009 U.S. Preventive Services Task Force (USPSTF) recommendation dictating otherwise, according to a study presented at the American Roentgen Ray Society (ARRS) meeting in Toronto.

A team led by Dr. Vilert Loving, director of breast imaging at Banner MD Anderson Cancer Center in Gilbert, AZ, used an Internet-based survey to gather opinions from 288 surgeons. The surgeons were divided into three cohorts: women at least 40 years old (group 1), women younger than 40 (group 2), and men (group 3).

In its 2009 guidance, USPSTF recommended that women be screened biennially beginning at 50 years of age and continuing through age 74. The task force reaffirmed that recommendation on April 20 after reviewing evidence from clinical trials.

But the study by Loving et al found that 88% of breast surgeons and 82% of general surgeons have been disregarding the USPSTF 2009 recommendations. An even higher percentage, 93%, said they began or would begin annual screenings for themselves at age 40.

In other results, 19% (18/94) of group 1 respondents said they will stop screening mammography at 75 to 80 years of age. The USPSTF recommendations affected 22% (50/226) of respondents' screening mammography recommendations for others and 14% (31/227) of respondents' personal screening behavior, according to the researchers. However, the changes varied from simply opening discussions with patients regarding the utility of screening, to switching from annual to biennial screening and initiating tailored risk-based screening.