The National Comprehensive Cancer Network (NCCN) recently updated the NCCN Clinical Practice Guidelines in Oncology™ for Breast Cancer Screening and Diagnosis and continues to recommend annual clinical breast examinations and mammography for women 40 years and older at normal risk. The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, a founding member of the NCCN, supports these recommendations.
The US Preventative Services Task Force's newly released recommendation that mammography screenings start at age 50 "work against women's health. They are putting women in jeopardy," says Ellen Mendelson, MD, Director of Breast and Women's Imaging at Northwestern's Lynn Sage Comprehensive Breast Center. "Given the decreased mortality of breast cancer patients under the age of 50, we have not altered our belief that annual mammograms for women age 40 and over are beneficial," concurs Virginia Kaklamani, MD, DSc, medical oncologist at the Lurie Cancer Center.
Annual clinical breast examinations and screening mammography, with breast awareness encouraged is stated in the NCCN Guidelines as a recommendation for women 40 years and older at normal risk. Although the interval of screening in women aged 40 to 49 remains controversial, the NCCN Guidelines clearly recommend annual screenings since mammograms can often detect a lesion two years before the lesion is discovered by a clinical breast examination.
"Age should not be the sole determining factor at either end of the spectrum when we consider who should have regular mammograms," says William Gradishar, MD, Director of Breast Medical Oncology at the Lurie Cancer Center. "If I see someone who's vibrant and vigorous in their 70s, I'm going to lean in favor of screening."
Therese B. Bevers, MD, University of Texas M.D. Anderson Cancer Center and chair of the NCCN Guidelines Panel for Breast Cancer Screening and Diagnosis, notes "It is imperative to consider the patient's individual risk factors when considering an appropriate screening routine." Dr. Bevers adds that adhering to a risk-based assessment method reinforces the concept that physicians should discuss the benefits and risks of screening with their patients.
The intent of the NCCN Guidelines for Breast Cancer Screening and Diagnosis is to provide health care providers with a practical, consistent framework for screening and evaluating a spectrum of breast lesions. However, the NCCN Guidelines Panel emphasizes that clinical judgment should always be an important component of the optimal management of a patient.
NCCN Clinical Practice Guidelines in Oncology™ are developed and updated through an evidence-based process with explicit review of the scientific evidence integrated with expert judgment by multidisciplinary panels of physicians from NCCN Member Institutions. The most recent version of this and all the NCCN Guidelines are available free of charge at NCCN.org
About the Lurie Cancer Center
The Robert H. Lurie Comprehensive Cancer Center of Northwestern University is committed to being a national leader in the battle to overcome cancer. To this end, the Lurie Cancer Center is dedicated to scientific discovery, advancing medical knowledge, providing compassionate, state-of-the-art cancer care, and training the next generation of clinicians and scientists.
First established at Northwestern University in 1974, the center was dedicated as the Robert H. Lurie Cancer Center of Northwestern University in 1991 through a gift of endowment from Ann and Robert H. Lurie. The title was modified in 1998, when the National Cancer Institute (NCI) awarded the Lurie Cancer Center the highly competitive "comprehensive" designation–reflecting the center's dedication to the highest standards of cancer research, patient care, education, and community outreach.
Today, the Lurie Cancer Center is one of only 40 NCI-designated Comprehensive Cancer Centers in the nation. In addition, the Lurie Cancer Center is a founding member of the National Comprehensive Cancer Network (NCCN), an alliance of 21 of the world's leading cancer centers dedicated to improving the quality and effectiveness of care provided to patients with cancer.
About the National Comprehensive Cancer Network
The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 21 of the world's leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives. For more information, visit NCCN.org.