In November 2010, the U.S. Preventative Services Task Force changed their mammogram guidelines from annually after age 40 to biannually starting at age 50. They also recommended stopping breast self-exams. Their reasoning was that less-frequent mammograms are just as effective in detecting cancer, and self-exams lead to increased and unnecessary doctors’ visits and procedures.
As you can imagine, this created quite a stir among doctors, especially those who have had patients between the ages of 40 and 50 with breast cancer detected by mammogram or self-exams. The data on mammogram effectiveness is conflicting, and women are left wondering about the ramifications of waiting until 50 for their first mammogram. Some physicians and women also wonder whether cost savings plays a role in the recommendations, though the USPSTF says it did not.
Mammograms are the standard of care in detecting breast cancer, and are the best tool we have for early detection. Its technology continues to improve, and currently, digital mammograms are in use in some areas. Most doctors continue to recommend self-exams and annual screenings for patients over 40, with high-risk patients starting mammograms earlier. The American Cancer Society also reviewed its guidelines last year, and it stands by the age of 40 to begin annual mammograms but neither recommended nor discouraged monthly self-exams.
Women under 50 tend to have denser breasts, making tumors difficult to see with mammograms, so for them self-exams are crucial. Most doctors will tell you that they’ve had many, many women find their own lumps during self-exams, and women know better than anyone else does what is normal for their breasts. Doing monthly self-exams is the best way to get to know your breasts so that if a lump does occur, you can detect it as soon as possible and treat it.
We encourage you to talk to your doctor about your individual risk factors and decide which mammogram schedule makes sense for you.
For more information on the USPSTF guidelines, as well as the ACOG revised guidelines for Pap smears, visit http://www.womenshealthmag.com/health/breast-health.