A controversy that has alternately simmered and boiled for more
than 40 years reached a flash point this week when the U.S.
Preventive Services Task Force published recommendations for
breast cancer screening with mammography. The recommendation to
delay routine screening in average-risk women until age 50
brought out ardent supporters on both sides of the issue, as
reflected in coverage by MedPage Today and in consumer and
professional media from coast to coast. Although media coverage
might have created the impression of a new controversy, the
strong, conflicting opinions go back at least as far as 1969,
when initial results of the first large-scale breast cancer
screening program were announced. Data from the Health Insurance
Plan (HIP) of Greater New York showed a 30% reduction in breast
cancer mortality in women ages 40 to 64 who underwent clinical
breast examination and screening mammography (JAMA 1971; 215:
1777-85). With longer follow-up, the HIP data suggested the
mortality benefit of screening was l