Cut through the mammogram confusion
ABC News “Good Morning America” anchor Amy Robach voiced the concern many women had when learning of the new American Cancer Society recommendations regarding when and how women should get screened for breast cancer.
The new recommendations suggest that women not begin receiving annual mammograms until they turn 45. Current guidelines, supported by the American College of Radiology and the Society of Breast Imaging, recommend that annual breast cancer screenings begin at age 40.
To add to the confusion, the U.S. Preventive Services Task Force recently reinforced its recommendation that annual screenings not begin until age 50.
Robach, a breast cancer survivor and past speaker at Candid Conversations, Spectrum Health’s annual breast cancer awareness event, pointed out that her cancer was discovered after a staged-for-television mammogram when she was only 40. Not considered at risk for breast cancer, her diagnosis came as a shock.
Under the American Cancer Society guidelines, “my cancer wouldn’t have been caught for years,” she concluded.
Specifically, the society is recommending:
- Women with an average risk of breast cancer—most women—should begin yearly mammograms at age 45.
- Women should be able to start the screening as early as age 40, if they want to. It’s a good idea to start talking to your health care provider at age 40 about when you should begin screening.
- At age 55, women should have mammograms every other year—though women who want to keep having yearly mammograms should be able to do so.
- Regular mammograms should continue for as long as a woman is in good health.
- Breast exams, either from a medical provider or self-exams, are no longer recommended.
The American Cancer Society notes that “these guidelines are for women at average risk for breast cancer. Women at high risk–because of family history, a breast condition or another reason–need to begin screening earlier and/or more often.”
Spectrum Health experts share Robach’s concerns about delaying annual screening.
Thomas Getz, MD, medical director of Spectrum Health Betty Ford Breast Care Services, said the American Cancer Society has done a “phenomenal job” working on these guidelines in terms of methodology and use of excellent research studies. However, he said Spectrum Health clinicians will continue to recommend the more stringent American College of Radiology and Society of Breast Imaging guidelines.
“There is good data that these regular screenings beginning at age 40 will continue to save more lives,” he said.
Dr. Getz believes that the American Cancer Society overstated the risks associated with earlier mammograms.
“Most well-informed women will prefer to accept the relatively minor risks to gain the benefits of staying with the current guidelines,” he said.
According to the American College of Radiology and Society of Breast Imaging:
- The incidence of breast cancer begins to noticeably increase around age 40.
- The most lives are saved when women begin annual screening at age 40.
- Early breast cancer detection reduces deaths, extends life expectancy, improves quality of life.
- Early detection enables less extensive surgery, fewer mastectomies, less frequent or aggressive chemotherapy.
- The over-diagnosis rate is very small.
- Very few invasive cancers are over-diagnosed.
- Women who experience a “false positive” still endorse regular screening.