In contrast to the letter recently printed (“Keep mammograms for those in 40s,” Renton Reporter, Nov. 27, 2009), I agree with the recent U.S. Preventive Services Task Force (USPSTF) recommendations, which advise against routine mammograms for women in their 40s.

Of course, there is nothing magical about age 40 or age 50 or every one year or every two years. We want to turn “gray” into “black and white” with arbitrary schedules, but it doesn’t work in the real world. If mammography is so great, and we want to “save every life,” why not monthly mammograms? It’s obvious we have to draw the line somewhere, that there is a point where the risks outweigh the benefits. I think the USPSTF has done a good job in drawing that line, based on actual evidence from randomized trials comparing women getting mammograms with those not getting them.

In any case, I think all would agree we need a better screening test than current mammography technology, which has large numbers of false positives and missed cancers and is neither simple nor cheap. According to evidenceinmedicine.org Web site, “If you imagine 1,000 women in their 40s getting mammograms yearly for 10 years, the best estimates are that you will cause more than half of them to need repeat mammograms for concerning findings and will cause nearly 200 to get breast biopsies, while only preventing two deaths from breast cancer.” I think it’s best to let the woman decide, based on real information such as the above, her risk history, and her personal values, in consultation with her doctor. If the woman chooses to leave the decision to her doctor, that’s her decision too.

Daniel Goldman, M.D.

Renton