By Gail Kalinoski, Contributing Reporter

The U.S. Preventative Services Task Force (USPSTF) has issued its final report on breast screening for women, saying once again that it recommends women with average risk for breast cancer should get mammograms every two years between the ages of 50 and 75.

The recommendations, similar to an April draft as well as its 2009 report, continue to be controversial with different age ranges suggested by other groups including the American College of Obstetricians and Gynecologists and the American Cancer Society.

ACOG is planning a late January conference and invited more than 30 organizations to discuss the issue and try and come to a consensus, according to The Wall Street Journal. That group recommends yearly mammograms beginning at age 49 while the ACS recently changed its guidelines to every year between age 45 and 55 and then every two years.

The Task Force did acknowledge that mammography screening every two years can reduce deaths from breast cancer but still suggested woman of average risk in their 40s should discuss the benefits of breast screenings with their doctors.

“The chance of benefiting from screening is less than for older women, and the potential harms are proportionately greater,” the Task Force said in a statement on its website. “For this reason, the Task Force recommends women ages 40 to 49 make their own decision whether and when to get a mammogram, in consultation with their doctors. This decision should be based on their health history, preferences, and how they value the potential benefits and harms of screening.”

For women 75 and older, and those with dense breasts, the Task Force said more study was needed to make guidelines.

So what’s different than the 2009 recommendations? For the first time, the Task Force considered effectiveness of digital breast tomosynthesis, noting the 3-D image is an emerging technology. The group stated there was very little evidence that 3-D mammography was ultimately effective in improving quality of life, or in reducing harms from treatment, or death, and so it could not make a recommendation on its use.

The group said it also reviewed studies of analog (film) mammography and digital mammography because it wanted to use all available evidence to help women make screening decisions.

“The evidence of how additional screening with an ultrasound, MR, or 3-D mammography may or may not help women with dense breasts is unclear,” the statement noted. “Therefore, the Task Force cannot make a recommendation for or against additional screening. These are all important areas for future research.”

In preparing its final report, the Task Force reviewed every comment received and made updates based on the comments. The Task Force said it updated or clarified terminology, such as “digital breast tomosynthesis”, and clarified the difference between misdiagnosis and over-diagnosis. The report also contains more context on potential radiation exposure risks during mammography.

Dr. Daniel Kopans, who supports annual mammography starting at 40, is among the specialists who are against the recommendations. A professor of radiology at Harvard Medical School and director of breast imaging at Massachusetts General Hospital, Kopans is known as the “father of breast tomosynthesis”. He told HCB News in April that the Task Force did not have any breast cancer experts on it and therefore placed too much emphasis on “false positives.”

Kopans said he agreed with the American College of Radiology that had claimed adoption of the recommendations would lead to thousands of additional breast cancer deaths each year.