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The New Mammography Guidelines: How to Make Sense of It All

While mammograms may not yet be perfect, screening continues to be important.
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Personalized medicine -- that is, tailoring medical care for each person based on her or his values and needs, genetics and family history of disease -- applies to screening as well as treatment. Every woman of any age should discuss with her ob-gyn or family doctor at what age and how frequently to have a mammogram.

  • ACS recommends that women of average risk for breast cancer begin annual screening mammograms at age 45 but agrees that women may rationally choose to start at age 40;
  • However, many other expert organizations, including the American College of Radiology (ACR) (statement here) continue to recommend mammograms every year starting age 40.
  • It is entirely reasonable for women to continue to get a mammogram every year starting at age 40. BCRF encourages women to speak to their health care provider, have a discussion about breast cancer screening guidelines and make an informed decision on what age and how often to be screened.

    Screening, by providing early detection, not only increases survival rates but it also minimizes the chances of needing a mastectomy or requiring chemotherapy. And, just as importantly, since annual mammograms have proved effective in finding tumors when they are small and at early stages, they can reduce the risk of the cancer metastasizing (spreading to another site). While every tumor biology is unique, in general, the smaller the tumor is when discovered, the more treatable it is, providing the best odds for a better outcome. In addition, early screening has been associated with the detection of lower risk, easier-to-treat cancers in many studies.

    Much of the public discussion about the risks of mammographic screening do not emphasize the fact that the risks are subjective in that they are largely limited to the person having an additional mammographic view or a sonogram and rarely a biopsy that proves that the mammographic finding is not cancer. The benefits, however, are objective. Everyone who studies the subject agrees that deaths from breast cancer are reduced by a percentage of women screened in any age group.

    While mammograms may not yet be perfect, screening continues to be important. Currently, grantees supported by BCRF are working diligently to develop even better (that is, more precise) imaging tools to improve upon mammography, while advancing the discovery of biomarkers and new technologies to distinguish between low risk and high risk breast lesions.

    Today, mammography is a critical component of our available breast cancer control strategies. At the same time, BCRF -- and the scientific community at large -- clearly has more to do to improve the state-of-the-art in the future. To accomplish our goals we need an informed and educated public that engages with us in seeking advances for the future. Originally shared with Family Circle, here are a few tips:

    Know where you stand. Starting in your 20s, talk to your ob-gyn or family physician about your breast health and family history starting so you can understand your individual risk factors for developing breast cancer and keep on top of the best screening recommendations for you.

    Research sites. Find a high-quality mammography facility near you by checking the American College of Radiology's list of Breast Imaging Centers of Excellence at acr.org.

    Get your results. Once you've had a mammogram, it's mandatory that the facility notify you in writing of the outcome within 30 days. If you haven't received word, don't shrug it off. Follow up.

    Keep your records. If you change doctors, request that all your mammograms be put on a CD-ROM or flash drive so you can take them to your new mammography facility.