New mammogram advice: what you need to know
The US Preventive Services Task Force, an expert panel that issues guidelines on preventive care, has recommended that all women begin routine breast cancer screening at age 40, rather than age 50 as previously recommended.
The panel continues to recommend that screenings be performed at two-year intervals, although some other medical organizations endorse annual mammograms.
Read more about what this means for you here.
For whom are the new guidelines important?
The advice applies to all “cisgender women and other people designated as female at birth” who have an average risk of breast cancer and have no unpleasant symptoms that could indicate breast cancer. This group includes women with dense breast tissue and a family history of breast cancer.
The recommendation does not apply to someone who has already had breast cancer, has genetic mutations that increase the risk of breast cancer, has received high-dose radiation therapy to the breast, or has breast lesions identified in previous biopsies.
Why did the task force change its advice?
The panel based its advice on recent, more inclusive science about breast cancer in women under 50. While no new clinical trial data was available — and only one older study included a significant proportion of black women — the panel ordered a review of screening strategies and modeling studies to reach conclusions.
The experts also took into account high mortality rates among black women. Those diagnosed with breast cancer in their 40s have twice the death rate of white women.
Why not annual mammograms?
When the task force makes recommendations, it tries to balance the benefits of mammography — lives saved — with the potential harms. Those include false-positive results that cause anxiety and lead to additional tests and invasive procedures, as well as overdiagnosis — the possibility of women being treated for “indolent” tumors that grow slowly and never become life-threatening. Mammograms also expose the breasts to radiation.
Mammograms save lives, but the panel’s research found no benefit for annual mammograms over biannual scans. Annual mammograms were no better at detecting stage 2 cancers and other dangerous tumors, they concluded. Modeling studies estimated that biennial screenings yielded a better benefit-to-risk ratio.
Does my insurance cover this?
Insurance companies are already required by law to fully cover mammograms each year for women aged 40 through 74 with an average risk of breast cancer. This advice does not change that.
Will starting screening earlier save lives?
The task force’s evaluation of the screening strategies indicated that the change could increase survival rates by nearly 20 percent. Overall, biannual screening starting at age 40 and continuing until age 74 will prevent 1.3 additional breast cancer deaths per 1,000 women, compared with screening beginning at age 50.
The benefits may be even greater for black women: An additional 1.8 breast cancer deaths avoided per 1,000 women, according to the panel’s report.
When can I stop screening?
Women should continue screening until age 74. After that it is not clear, because there is no data on women aged 75 and older. The consensus seems to be that if a woman is in good health and has a life expectancy of at least another 10 years, she should continue to receive mammograms.