Thoughts on New Mammogram Recommendations
By Melissa Schiffman, MD
Patients are asking about the new recommendations for mammogram screening released by the U. S. Preventive Services Task Force in November.
Previously, we had recommended a yearly mammogram for most women age 40 and older. The new statement from the task force recommends starting mammograms at age 50, and then getting them every other year.
This new advice is based on rigorous review of the scientific data. However, other physician groups and organizations have come to other conclusions. For example, the American Cancer Society still recommends mammograms for all women age 40 and up.
When deciding whether to have a mammogram, it is important to consider a few facts:
- Some women may be at higher risk for breast cancer.
- Mammograms are not a perfect screening test. Having a mammogram every year (starting at any age) does not prevent all cases of deadly breast cancer.
- Some breast cancers might be very slowly growing; a cancer could be present for several years before it starts to grow and spread. Some very early cancers may even go away without treatment.
- Other breast cancers are so aggressive, and grow so fast, that you could have a normal mammogram one year, but the cancer could grow and spread before it is time for your next mammogram a year later.
- Many spots that appear possibly abnormal on a mammogram turn out to be “false alarms” and may result in tests or surgery that turn out to have been unnecessary.
What we at Greenhouse recommend:
- If you are at high risk for breast cancer, you should continue to get a yearly mammogram starting at age 40 (or younger, if indicated). You can evaluate your breast cancer risk at http://www.cancer.gov/bcrisktool/
- If you are at low or average risk for breast cancer, it is your personal preference whether to go by the new or old recommendations. Some women are happy to undergo mammograms less often due to discomfort, worry and risk of possibly unnecessary procedures. Other women prefer to continue getting a yearly mammogram and are willing to accept the risk of more tests and procedures.
- Realize that breast cancer is still a serious health problem for women. If you have any concerns about your breast health—if you feel a lump, pain, swelling or see a change in your breasts—you should come in right away for evaluation, no matter what your age or when you most recently had a mammogram.
There will likely be an ongoing debate in the medical community about this topic, and the recommendations may change in upcoming months or years. Even among the doctors at Greenhouse, we each have a slightly different view of how to use these new recommendations in our own practice.