Mammogram guidelines: What's changed?

I've heard there are new mammogram guidelines that call for beginning mammograms at age 50 instead of age 40. When should I start getting mammograms and how often should I have one?
from Sandhya Pruthi, M.D., Mayo Clinic

The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that reviews published research and makes recommendations about preventive health care.

The USPSTF has issued new mammogram guidelines. These recommendations include:
• Screening mammograms should be done every two years beginning at age 50 for women at average risk of breast cancer.
• Doctors should not teach women to do breast self-exams.
• There is insufficient evidence that mammogram screening is effective for women age 75 and older, so it's not recommended for this age group.

Differing mammogram guidelines
These guidelines differ from those of the American Cancer Society (ACS). ACS mammogram guidelines call for yearly mammogram screening beginning at age 40 for women at average risk of breast cancer. Meantime, the ACS says the breast self-exam is optional in breast cancer screening.

According to the USPSTF, women who have screening mammograms die of breast cancer less frequently than do women who don't get mammograms. However, the USPSTF says the benefits of screening mammograms don't outweigh the harms for women ages 40 to 49. Potential harms may include false-positive results that lead to unneeded breast biopsies and accompanying anxiety and distress.

What Mayo Clinic recommends
At Mayo Clinic, the current practice is to continue to recommend an annual screening mammogram beginning at the age of 40, which aligns with the ACS recommendation.

At Mayo Clinic, a three-tiered approach is used which includes:
• Breast self-exam to identify breast abnormalities and allow a woman to become familiar with her breasts so that she can tell her doctor about any changes
• Clinical breast exam performed by a health care provider and recommended annually beginning at age 40
• Screening mammography beginning at age 40

Screening mammograms have detected abnormalities in women in their 40s. These women have then had biopsies and learned they had invasive breast cancer. There are many stories about younger women who have found cancer early as a result of screening.

And it's important to remember that most women who get breast cancer have no family history or other risk factors for the disease.

Screening mammography is not a perfect exam. There will be a lot of new data published in the coming months, and it will take time to analyze the results and see what information can be gained to determine how best to use mammography as a screening tool.

In the meantime, women should meet with their health care providers to discuss the benefits, risks and limitations of screening mammograms. If you're concerned about screening mammograms, talk to your doctor and learn what's right for you based on your individual risks. It's important that the two of you work together to develop a screening plan.

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