New mammogram guidelines, new confusion

It’s October, and pink ribbons abound as the nation recognizes Breast Cancer Awareness Month. The effort in recent years to raise public awareness and encourage women to schedule a regular mammogram has naturally left many women wondering how often they should be receiving breast cancer screening. This confusion is compounded by the fact that breast cancer screening recommendations differ depending on whose guidelines you choose to follow.

Like many other cancers, early detection is absolutely key when it comes to effectively treating this disease. As an oncologist who regularly treats breast cancer patients, I feel it is critically important to address some of this confusion that surrounds mammogram guidelines and breast screening guidelines.

Earlier this year, the U.S. Preventive Services Task Force updated their guidelines on breast cancer screening to state that women ages 50 to 74 should be screened every other year. This is in contrast to several other groups’ mammogram guidelines that recommend annual screenings for women in this age range.

For women aged 40 to 49, the Task Force states that mammograms should be optional, and the decision to be screened should be based on a woman’s risk factors, preferences and personal values. A number of other groups, such as the American College of Obstetricians and Gynecologists and the American College of Radiology, recommend annual screenings beginning at age 40, regardless of risk factors or preferences.

Ultimately, the decision to get a mammogram is an individual one

As you can see, these guidelines and recommendations can make your head spin. To clear up some of this confusion, I’d like to share some of the advice that I offer my patients. Firstly, and most importantly, the decision to get mammogram screening prior to age 50 should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to get a mammogram every other year between the ages of 40 and 49 years.

The potential harms of regular mammograms are minimal, but they include false positive diagnoses and a small amount of radiation exposure. In my experience, most of my patients place a higher value on the potential of early detection through mammogram screening, particularly if they are at a higher risk of developing breast cancer.

Know your risk and don’t be afraid to ask questions

The overall risk for developing breast cancer increases for all women as they get older, which is why all of the published guidelines recommend some type of regular screening after the age of 50. Family history (particularly if someone in your immediate family was diagnosed), genetic mutations, lifestyle choices and even breast density up the risk. If you’re concerned or have questions, my advice is to make an appointment with your doctor and ask questions. You may even find it helpful to write out your questions in a list and bring it with you to your appointment.

The most important thing to remember is that breast cancer screening guidelines are just that: Guidelines. They’re helpful but they don’t tell the whole story, because everyone is truly different. To determine your individual risk factors and your optimal screening plan, don’t hesitate to make an appointment with your doctor.