The issue addressed by the Guidelines Workshop centered on the questions, "Should the American Cancer Society Guidelines for breast cancer screening remain unchanged? If not, how should they be changed?" Rationale pro and con is needed. After a general discussion on procedure and amplifying statements related to some of the material covered at the previous session, the workshop group addressed in sequence the following topics covered by the current American Cancer Society Guidelines: (1) baseline mammography at 35 through 39 years of age; (2) screening at 40 through 49 years of age; (3) upper age limit for screening; (4) periodicity of screening; ( 5 ) breast self-examination (BSE); and (6) clinical breast examination (CBE) (Table 1).
Strong dffering points of view were advanced on most of these topics but, in the end, recommendations were adopted unanimously on all of the issues. This workshop was influenced in many instances by the unavailability of evidence requiring a change.
Note that, on several issues, there was agreement on amplifying statements to inform the American Cancer Society and others more fully the intent behind the recommendations and the need for additional studies. The point was made repeatedly that a more detailed analysis of the evidence affecting the guidelines should be undertaken by the American Cancer Society National Advisory Committee on Cancer Prevention and Detection and that a report be prepared explaining the basis for the guidelines (results of studies, expert opinion).