Holly SaundersHolly Saunders, MD
Breast Imaging and Intervention

Women are now being told they should get mammograms every other year starting at age 40 – 10 years earlier than previous recommendations.

Radiologists and cancer specialists are applauding the new recommendation from the U.S. Preventive Services Task Force, but many medical associations think it should go further and tell women to have mammograms yearly, not every other year.

What New Report Says About Mammograms

If you’re 40, make an appointment for a mammogram. That’s the key point by the U.S. Preventive Services Task Force, an independent group not affiliated with any government agency. The experts concluded this after re-examining existing data.

The group changed its recommendation in part because various subsets of Americans have different breast cancer risks and experiences, including:

  • Skin color. Black women are 40 percent more likely to die from breast cancer than white women. Their tumors are often more aggressive, and the women are less likely to receive care quickly enough. The report calls for more “urgently needed” research, too, into breast cancer screening and treatment regarding Hispanic, Latina, Asian, Pacific Islander, Native American and Alaskan Native women.
  • Ethnicity. Women of Jewish descent, and some others, also have a higher risk of developing breast cancer.
  • Dense breasts. It’s harder to see cancers in women with dense breasts even with mammograms, and that’s nearly half of all women.
  • Transgender women. Biological males who transition to females are more likely to get breast cancer than they would be otherwise.

It’s also crucial to look at the data. In recent years — 2015 to 2019, women in their 40s have been diagnosed with breast cancer 2 percent more often than in the five years before that. The reason for the spike isn’t clear, but the need for action, i.e., mammograms at this age, is obvious.

After deep study, the task force concluded that starting mammograms nationwide at age 40 will save 19 percent more women’s lives.

Other Medical Groups Want More Mammograms

The task force took a step in the right direction. It’s just not quite far enough.

Several other professional groups have long called for not only mammograms at a younger age, but also mammograms every single year. They continue to urge women to schedule a mammogram annually. Most private insurance is required to provide coverage for an annual screening under the Affordable Care Act.

In response to the task force’s announcement, the American College of Radiology and Society of Breast Imaging issued a joint statement urging the task force to call for annual mammograms.

“Medical experts should clear the confusion caused by different recommendations and agree to recommend yearly mammography for average-risk women starting at age 40,” the formal statement says.

Doubling down on that thought, in a New York Times article about the task force announcement, the American Cancer Society’s CEO, Karen E. Knudsen said, “ We are steadfast on annual screening. Cancers in premenopausal women grow faster, and it’s important they don’t develop during the two-year period and go undetected.”

Mammograms a use a special X-ray machine to detect tumors and other abnormalities in breast tissue. The types are digital mammography and digital breast tomosynthesis, also known as 3D mammograms. The task force says both work effectively.

Women at higher risk for breast cancer can also opt to have additional testing via diagnostic mammograms, sonograms and/or MRIs.

So Much To Consider

It’s confusing. Which set of age guidelines should you follow? Which tests should have? And how often?

Screening-detected cancers are usually smaller and found at an early stage, so treatment is very effective. Therefore, it’s crucial to find and treat breast cancers when they’re very small. Still, one in eight U.S. women will have breast cancer in their lifetime. According to the American Cancer Society, 254,000 breast cancers are diagnosed domestically each year, and 43,700 women die of breast cancer annually.

The doctor ordering your exam will consider several factors, including:

  • Age group.For women of average risk, the medical community generally divides women into 40-49, 50-74, and 75 and up. All medical groups call for women 50 to 74 to be screened for breast cancer regularly, as that’s when it occurs most often.
  • Your risk assessment.By age 30, women should sit down with their doctor for a breast cancer risk assessment. That means looking at genetics, race, family history, breast tissue density and other factors. The goal: measuring the chances of getting breast cancer.
  • How you feel about further testing.If any breast-screening test shows a possible abnormality, you’ll be sent for further testing, which may include a biopsy to determine if it’s cancer. Biopsies are uncomfortable, anxiety-provoking and expensive.

After lung cancer, breast cancer is the most deadly cancer for American women. If you follow the U.S. Preventive Services Task Force advice by starting mammograms at age 40, especially if you have them yearly, you will be making the best choice for your breast health.

 

Source: Orlando Health, www.orlandohealth.com