New Mammogram Guidelines

October 28, 2015 | Health Advice | By: Naomi Wyatt

You have probably seen the uproar in the media over the past few days regarding changes in breast cancer screening guidelines.  There has been discussion on the news, talk shows, Facebook, and it seems everywhere else you turn.  So what are these ‘new’ recommendations, who is making them, and what’s all the fuss about?

Breast cancer is the most common cancer among worldwide, and in this country about 230,000 cases are expected to be diagnosed in 2015 with an estimated 40,300 deaths.  With a disease this common everyone wants to do the best thing when it comes to diagnosis.  The confusion comes when there are different groups of experts making different recommendations.  Let’s go over the two big groups that make recommendations on this, and how their recommendations differ.

First the USPSTF (lots of letters, this stands for the United States Preventive Services Task Force) is the federal group that issues expert recommendations on screening for many different things including breast cancer.  This group recommends that mammograms should start at age 50, and be done every other year until age 75.

The group that changed its recommendations this week was the American Cancer Society (ACS).  They had put out recommendations in 2003 recommending yearly mammograms starting at age 40 and clinical breast exams (breast exams done by your medical provider) yearly starting at age 40 as well.  The new guidelines this week state that women with an average risk of breast cancer–so most women–should begin yearly mammograms at age 45 (not 40, as previously recommended) and have them yearly until age 54.  They recommend that from age 55 on women should have mammograms every other year, though say that women who want to continue to have yearly mammograms should be able to do so.  The new guidelines recommend to continue regular mammograms as long as the woman is in good health and expected to live 10 or more years.  The ACS guidelines do state that women should be able to start the screening as early as age 40 if they want to, but urge patients to talk to their health care provider starting at this age to determine when you should begin screening.  They also no longer recommend breast exams, either self or by a medical provider as these do not have good evidence of benefit, and may have false positive abnormal findings.  [Remember: these recommendations are for women with average risk, not those with a family history of breast cancer or a specific gene that predisposes them to breast cancer.  Women with increased risk may need earlier and more frequent screenings.  ]

So what does this mean for you?  Are you still confused?  Talk to your provider!  The goal of screening mammograms is to find breast cancer early, when treatment is more likely to be successful.  Mammograms aren’t perfect however, and they do have risks.  Sometimes mammograms find something suspicious that turns out to be harmless, but lead to further testing and procedures that end up being unnecessary.  This discussion focuses on greater awareness of the harms of false positive mammograms and the harms of over-diagnosis, which basically is when you’re diagnosed with a cancer that would never become ‘clinically evident’ (a problem) in your lifetime, and are then treated for a cancer you may never have needed to deal with.  A discussion with your provider can help you to determine your risk factors, explain the risks of screening, and decide what course of action you feel most comfortable with.  We can help personalize the guidelines to you, and answer any questions you may have.  Your providers at Post Rock are happy to be your partner in health!

Article By: Dr. Beth Oller, M.D.