NIH Consensus Statement on Breast Cancer Screening for Women in Their 40s: How Will It Affect Patient Care?

It is generally accepted that breast cancer screening mammograms in women 50 years of age and older has saved lives. It also is generally accepted that the incidence of breast cancer in women younger than 40 is too small to warrant subjecting young women to the risks associated with mammograms. But whether women in the transition years from 40 to 49 should have routine screening mammograms has been debated for 2 decades. On January 23, the NIH Consensus Statement on Screening Mammograms for Women Ages 40 to 49 lit a powder keg when, after 2-and-a-half days of hearings and study, it announced "The data do not support a universal recommendation that all women in their 40s should undergo screening mammography." Many experts have challenged the conclusion and advocated screening mammograms every 1 to 2 years starting at age 40. To sort out the impact of the NIH statement and determine where clinicians and consumers stand, Medscape launched its first on-line survey on January 30. Most Medscape responders agree that screening mammograms every 1 to 2 years should begin at age 40 and fear that third-party health care payers will use the conclusion of the NIH consensus panel to deny reimbursement for screening mammograms in women younger than 50 years of age.