Recently, a panel of experts that issue guideless about preventative care (known as the US Preventive Services Task Force), has recommended that all women start routine breast cancer screening at age 40 and then get a screening every TWO years, although some medical organizations like the American Cancer Society continue to recommend an annual screening. The previous recommendation from 2009 was to start routine screenings at 50 years old. The new recommendations come on the heels of an alarming increase in breast cancer diagnoses among younger women, and high death rates among Black women. Furthermore, the advice does not apply to anyone who already has had breast cancer or who has had high-dose of radiation to the chest.
Even though no new clinical trial data was used, the panel drew its conclusions based on recent more inclusive science about women under 50. Importantly, the panel noted that Black women diagnosed with breast cancer in their 40’s have double the mortality rate of white women diagnosed in their 40’s. The experts decided not to recommend annual mammograms because it thought the benefits did not outweigh the costs. In other words, they deemed the benefit of lives saved did not outweigh potential harms, like false-positive results that cause anxiety and lead to invasive follow-up procedures.
Mammograms certainly save lives, but the panel’s research found that annual mammograms were no better at detecting Stage 2 cancers and other dangerous tumors than scans every two years. The American Cancer Society disagrees, and says that annual screenings at a young age are important because cancers in premenopausal women grow faster and it’s important that the cancer does not go undetected for two years.
Even though overall breast cancer mortality has declined in recent years, it is still the second leading cause of cancer deaths among women in the US, and the panel believes that many lives can be saved if women start getting mammograms earlier, at age 40. In fact, the research shows that the change could increase the survival rate by nearly 20 percent. This is significant and would mean that 1.3 breast cancer deaths per 1,000 women could potentially be avoided. For Black women, the benefits may be evenhigher and could save 1.8 breast cancer deaths per 1,000 women.
Additional good news is that this will not cost women any extra money. Insurance companies are already legally required to fully cover annual mammograms for women ages 40 through 74 who are at average risk of breast cancer. The new guidelines will not change that.
While the current advice says that women should continue screening until age 74, it is important to understand that that advice is solely on the basis that there is insufficient data for women age 75 and older. So, if a woman is in good health and has a life expectancy of at least another 10 years, the logical consensus is that she should continue receiving mammograms after age 74.
At Southwest Family Physicians, we feel strongly about supporting and empowering women’s health so if you have any questions about the new guidelines or mammograms in general, please schedule an appointment and come see us. We would be happy to talk with you about these recommendations and assist you in making the best decision for you.
