The United States Preventive Services Task Force (USPSTF) announced last Friday that it is going to review its guidelines for breast cancer screening. The process by which the utility of a screening test is determined must be transparent, free of bias and based on the best science available. Back in 2009 the USPSTF decided that women 50-74 only need a mammogram every other year and women under 40 should make an individual decision with their doctor. This, despite ample evidence that mammography saves lives and is efficacious in doing so even for younger women.
At a time when the health care system is trying to function more effectively at lower cost we have to hope that the policy makers and members of the USPSTF will focus on the science and make a decision that reflects that.
It’s 20 years since I was a breast imaging fellow with Dr. Dan Kopans at Massachusetts General Hospital. The misinformation about the value of screening started back then with the Canadian National Breast Screening Study, which was inherently deeply flawed. Alas the drumbeat of scepticism has beat steadily since. Cascading reimbursement cuts to imaging have impacted the availability of mammography services. If the new bundled breast biopsy codes are, as has typically been the case with bundled codes recently, associated with significant decreases in reimbursement, access may decline even further.
Breast cancer awareness month has passed but rest assured that your team at the American College of Radiology works to maintain access to this life saving service for our patients all year round.
Author – Geraldine B. McGinty, M.D., MBA, FACR