Saving lives: mammograms, breast cancer, and health insurance reform.

i p h c i he vigorous controversy about the ecent recommendation of the US reventive Services Task Force USPSTF) [1] against routine creening mammography for heathy, low-risk women aged 40 to 0 years has demonstrated our road national consensus about the alue of preventive medicine in eneral and breast cancer screening pecifically. Nonetheless, many of he recent dissenting commentaries n this issue from concerned proessionals [2], professional organiations [3], patients and their loved nes, and politicians have been narowly focused and have tended to verlook important considerations. t is important to review this whole ssue in the context of the actual se efficacy and consequences of creening mammography and its mpact on breast cancer mortality. In its new report, the USPSTF 1] recognized that “the risk for reast cancer increases with age. he 10-year risk for breast cancer is in 69 for a woman at age 40 years, in 42 at age 50 years, and 1 in 9 at age 60 years” (p 720). Its reommendation concerns “routine creening,” not mammography one for high-risk patients such as hose who have breast masses, trong family histories, or abnormal enes or who may request screenng. The USPSTF updated its 2002 ecommendations based on pubished data from a meta-analysis of andomized, controlled clinical trils that estimated the “‘number eeded to invite for screening [for 0 years] to extend one woman’s ife [prevent 1 death]’ as 1904 for s