WOMEN (WITH AVERAGE RISK) SHOULD GET SCREENED for breast cancer every other year starting at age 40. This recommendation is according to draft guidance recently issued by the United States Preventative Services Task Force. Today, we examine this proposed new breast cancer screening guide.
Breast cancer is quite manageable when discovered early. Mammograms — X-ray images of the breasts — are a reliable screening tool for finding breast cancer.
New draft recommendations from the U.S. Preventive Services Task Force suggest that all women get screened every other year, starting at age 40.
“When I was in medical school, I embarrassed myself horribly when I found a ‘lump’ in my breast and frantically ran to one of the older doctors to find out if I had cancer. I found out I had a rib.”
― Susan M. Love, Dr. Susan Love’s Breast Book
Proposed Breast Cancer Screening Guidelines
The US Preventative Task Force previously recommended that women start having mammograms at age 50. It also suggested that those 40 to 49 should consider it, depending on their risk.
On the other hand, the American Cancer Society recommends that women 40 to 44 who are at average risk should “have the option” to start screening but stops short of recommending it for all women until age 45.
Now, the growing evidence has nudged the Task Force to recommend mammograms for all people assigned females at birth who are at average risk for breast cancer and age 40 or older.
Why do the new guidelines matter? The Task Force recommendations are the gold standard as they are based on a thorough review of evidence by an independent expert group.
Listen to Dr. Carol Mangione, immediate past chair of the task force, speaking to the New York Times:
“We don’t really know why there has been an increase in breast cancer among women in their 40s. But when more people in a certain age group are getting a condition, then screening of that group will be more impactful.”
The USPSTF also issued two draft recommendations. The task force concluded that there is not yet enough evidence to determine:
- if women with dense breasts should have additional screening with breast MRI or ultrasound; and
- the benefits and harms of screening in women aged older than 75.
The US National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) reports that, since mammography became widespread in the 1980s, the breast cancer death rate in women (unchanged for the previous 50 years) dropped 43 percent.
Breast cancer deaths in men, who are treated similarly to women but do not have screening, have not declined.
Mammogram Benefits
Here are some of the benefits of mammograms:
- Screening mammography drops the risk of breast cancer death. This imaging approach helps detect all breast cancer types, including invasive ductal and invasive lobular cancer.
- Screening mammography improves a clinician’s ability to detect small tumors. When cancers are small, a woman typically has more management options.
- Screening mammography increases the detection of early abnormal cells confined to the milk ducts (ductal carcinoma in situ).
- No radiation stays in your body after a mammogram.
Mammogram Risks
And here are some benefits of mammograms:
- There is always a slight chance of cancer from radiation exposure. However, given the small amount of radiation used in medical imaging, the benefit of an accurate diagnosis far outweighs the risk.
- False positive mammogram results. Approximately five to 15 percent of screening mammograms lead to more testing (for example, additional mammograms or ultrasound). These tests often are normal. A follow-up biopsy or follow-up imaging may be needed if mammograms show an abnormality. For a woman 40 to 49, there is a three in 10 chance of having a false-positive mammogram at some point in that decade (and seven to eight percent odds of needing a breast biopsy).
- Women should always tell their doctor and X-ray technologist if they are pregnant.
Who Benefits From the New Breast Cancer Screening Guidelines?
BREAST CANCER MORTALITY HAS RECENTLY DECLINED. Nevertheless, it remains the second most common cancer (after skin…
Key points — New Breast Cancer Screening Guide
Question. What has changed in the US Preventative Task Force breast cancer screening recommendations?
Findings. Every two-year screening, beginning at 40 and continuing until 74, should prevent 1.3 breast cancer deaths per 1,000 women (compared with screening beginning at 50). Black women might get even more benefits.
Meaning. I hope that starting screening at 40 will help address the rising incidence of breast cancer among young people and the high breast cancer mortality in Black Americans. The new advice does not apply to anyone who has had breast cancer, has had concerning breast lesions in prior biopsies, carries genetic mutations that increase her risk or has had high-dose radiation to the chest. These women should consult a valued healthcare provider about an optimal screening approach.
If you know someone with breast cancer, here is my comprehensive online course:
Breast Cancer – What a Patient Needs to Know.
Breast cancer information can be incredibly valuable for navigating breast cancer management.
breastcancerbydrhunter.thinkific.com.
The information I provided in this blog is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider for medical advice, diagnoses, or treatment. I am not liable for risks or issues associated with using or acting upon the information in this blog.
Thank you for reading the “New Breast Cancer Screening Guide.”
