Doctor helping administer mammogram to woman

Earlier this week the American Cancer Society (ACS) issued updated mammogram screening guidelines for women at average risk for breast cancer (defined as no personal history of breast cancer, no suspected or confirmed genetic risk, and no history of radiotherapy to the chest at a young age). The ACS plans to release further screening guidelines for women with intermediate and high risk at a future date. This includes women with increased breast density, benign proliferative disease, and significant family history of breast cancer.

The updated ACS guidelines recommend that women with average risk for breast cancer start getting mammograms at age 45 (rather than 40) and that they continue screening once a year until 54, then every other year for as long as they are healthy and likely to live another 10 years. This updated guidance from ACS has prompted discussion amongst the medical community and patients about how much screening is appropriate. There is understandable confusion. Three well-respected, important, national groups provide three different guidelines. The American College of Obstetricians and Gynecologists recommends regular mammograms starting at 40, ACS recommends starting at 45, and the U.S. Preventive Services Task Force recommends starting at 50.

What are patients – particularly women in their 40s - supposed to do?

Talk to your doctor. The overarching message is that patients should be aware of the risks of screenings (such as false positives) and the benefits (early detection of cancer and other abnormalities). There simply isn’t a one-size-fits-all approach. The conversation about breast cancer screening should start at age 40 for women with average risk for breast cancer. You and your doctor can make a screening decision together based on family history, density of breast tissue, and other health factors.

Every time updated screening guidelines are released it prompts an important national discussion about the pros and cons of screenings. The most important discussion you can have is the one with your doctor about what’s best for you.

October 23, 2015 | by F. Ames Smith Jr. MD, FACS