Progress Toward Consensus on Breast Cancer Screening Guidelines and Reducing Screening Harms

To the Editor I applaud the members of the medical community who have taken the lead in the fight against breast cancer; however, the idea that there is progress toward a consensus on breast cancer screening guidelines from a recent article1 in JAMA Internal Medicine is misconstrued. New recommendations from the American Cancer Society maintain that women should have every opportunity to begin breast cancer screening at the age of 40 years. Yet, the Grade C recommendation put forth by the US Preventive Screening Task Force (USPSTF) for women age 40 to 49 years jeopardizes the benefit of early detection in women for whom the number of years of life lost is the greatest.2 The USPSTF recommendation to begin mammography screening at age 50 years instead of 40 years denies this benefit to the 20.6 million women in their fifth decade of life.