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The fallout from Monday's mammogram story dominated the headlines. All three networks had their in-house physicians do a house fall to answer frequently asked questions about screening for breast cancer. The Preventive Services Taskforce recommended that fewer fortysomething women have mammograms and that women older than 50 have them less frequently. The Story of the Day was the reaction to those guidelines. NBC and ABC chose breast screening for their lead, with NBC anchoring on the road in Phoenix. CBS decided to kick off with Barack Obama's summit with Hu Jintao in Beijing instead.

NBC's in-house physician Nancy Snyderman tended to endorse the taskforce's recommendation to scale back mammography. ABC's Dr Timothy Johnson tended to reject it. CBS brought in its pair of doctors: Jon LaPook was pro; Jennifer Ashton was con. "My patients are so angry about this. They feel almost personally attacked. They are afraid. They do think it is about cost and money…I share their frustrations."

There are two ways of seeing the guidelines as being about "cost and money," as Dr Ashton put it. ABC's John McKenzie represented it one way: "The concern is insurance companies will soon use the new guidelines to start limiting what they will cover." CBS' Dr LaPook spelled out how wasteful the current system is: 90% of abnormal mammograms turn out not to be cancer; this leads to 1.6m women each year undergoing biopsies "the vast majority turning out to be false alarms;" these errors occur disproportionately in women who are under 50; lowering the starting age for mammography from 50 to 40 raised the error rate by 60%.

Dr LaPook on CBS also pointed out that even when a mammogram happens to discover a tumor, it is not certain that it saved that woman's life. Some breast cancers grow so slowly that early detection is not necessary; other breast cancers spread so quickly that even early detection is too late. Mammography saves lives only when the tumor falls in between.

ABC's McKenzie checked in with the American Cancer Society, the Mayo Clinic and the MD Anderson Cancer Center and found "outright revolt." All three have rejected the new screening guidelines. "I would recommend staying with the current guidelines while we have an open debate," Dr Johnson chimed in on ABC. On NBC, Dr Snyderman reminded us that "anecdotes and this big body of science do not necessarily jibe." She predicted that younger doctors will prescribe fewer mammograms while those "who are entrenched…will be a little slower to pick up on these recommendations."

Andrew Tyndall 11/21/09 6:22:22 pm

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