The Myth of the Baseline Mammogram

See also Mammography

While many things about screening mammograms are uncertain, there's at least one thing that is certain: baseline mammograms shouldn't be recommended as a routine part of health care for women. There is complete agreement about this, even among organizations that disagree on almost every other aspect of mammography.

But, despite this agreement that baseline mammograms aren't necessary and shouldn't be recommended, many women tell us that their practitioners start recommending baseline mammograms at age 35. Why is this? In part, it's because American Cancer Society (ACS) spent over a decade promoting baseline mammograms as an essential part of screening for breast cancer. The ACS recommendation had no scientific evidence to support it'there are absolutely no studies showing any benefit of a baseline mammogram in women under 40?but the ACS recommendations reached and influenced the majority of U.S. physicians, nurse practitioners, and physician assistants.

The ACS received steady criticism of its recommendation in favor of baseline mammograms and finally withdrew it in 1992. The ACS did not, however, promote this change and the message still hasn't gotten out to well-meaning practitioners who continue to tell women in their 30s that its time for their baseline mammogram.

For more information about the history of the mammography debate, see

• Sharon Batt, Patient No More: The Politics of Breast Cancer, Charlottetown, P.E.I.: Gynergy Books, 1994.
• Barron Lerner, MD., The Breast Cancer Wars: Hope, Fear and the Pursuit of a Cure in Twentieth-Century America, New York: Oxford University Press, 2001.

Reference:
"Chronological History of ACS Recommendations on Early Detection of Cancer"