The ACS now recommends that women begin mammograms later, and have them less often
Today, the American Cancer Society (ACS) issued a major change to their breast cancer guidelines, recommending that women start their annual mammograms later and have fewer than previously recommended. (The guidelines haven't been changed since '03, so this is big news!)
The updated guidelines, published in the Journal of the American Medical Association, are the result of an extensive development process with a group of clinicians, biostaticians, epidemiologists, patient representatives, and even an economist, who voted on each recommendation. All in all, they're intended to reduce the number of deaths from breast cancer while also putting greater emphasis on the harm that can come from unnecessary mammograms, the ACS explains.
While the ACS previously recommended mammograms for women every year starting at 40, the update pushes back the recommended age to begin to 45. They suggest women continue mammograms every year until 54, then switch to every two years (or continue yearly screening if they want) and continue as long as they are in good health and expect to live 10 more years or longer. (Here, six women share "What I Wish I Knew About Breast Cancer in My 20s.")
And remember the whole idea of a doctor manually checking for lumps? That's out too (for women of any age) since there’s no evidence these exams save lives, the ACS says. They do, however, stress that you should be familiar with how your breasts normally look and feel and let your doc know of any changes right away.
While mammograms are no longer suggested for women ages 40 to 44, the ACS states that women in this bracket still have the choice to discuss risks and benefits of screening with their doctor, and can start annual screenings if they choose.
The reason for upping the age? Evidence finds that mammograms are less useful in younger women, and can even have serious drawbacks, like overdiagnosis and false-positive results that can lead to biopsies. In fact, studies have shown that between five to 50 percent of women treated for early-stage breast cancer may be undergoing surgery, radiation, and chemotherapy for cancers that would never cause them harm, the Wall Street Journal reports. (Good news: Scientists have created a new blood test that may predict breast cancer even more accurately than mammograms.)
"It's not that mammograms are ineffective in younger women," said Richard Wender, M.D, the ACS' chief cancer control officer, but at age 40, breast cancer is uncommon and false alarms are more likely. "The most important message of all is that a mammogram is the most effective thing that a woman can do to reduce her chance of dying from breast cancer."
It's important to emphasize these guidelines apply only to women considered of 'average risk'—women with a personal history of breast cancer, a family history of breast cancer, a genetic mutation known to increase risk of breast cancer (such as BRCA), and women who had radiation therapy to the chest before the age of 30 are all at higher risk for breast cancer, and thus more rigorous screening is suggested. (See these 6 Things You Don't Know About Breast Cancer.)
If it sounds like there are a lot of caveats in these updates, you're right. At the end of the day, these guidelines are written with the understanding that you will factor in your own values and preferences to make an individual decision when it comes to screening.
In other words, the new guidelines are intended to do just that—provide guidance when it comes to breast cancer screening, rather than black and white rules.