New Guidelines Recommend Mammograms at Age 50, Discourage Self-Exams

The recommendations made by the United States Preventative Services Task Force differ from those offered by some professional organizations, and represent a development in thought from seven years ago, when the group recommended that women begin screening at age 40.

The changes are an effort to prevent unnecessary treatment and avoid the risks associated with mammograms. Some of these risks include radiation exposure, pain during the test, false-positive results, and false reassurance. If a mass is found during a mammogram, doctors usually recommend that patients receive a biopsy and/or radiation to treat possible cancer, even though a mass may be benign.

The new guidelines are likely to spark controversy. Similar guidelines issued by the American College of Physicians in 2007 elicited a broad range of responses. USA Today responded by writing that “breast cancer is the second leading cause of cancer-related deaths among U.S. women—including young women … far too many women do not submit to mammograms, for reasons from avoiding the unpleasant procedure to lack of insurance. Giving them more reasons isn’t helpful.”

Conversely, the Cancer Prevention Coalition called mammography screening “a profit-driven technology posing risks compounded by unreliability.”

The ACP recommended that all women over age 50 receive a mammogram every year, and that women under 50 undertake a breast cancer risk analysis with their doctor to decide whether to have a mammogram. The guidelines were changed after the group found that the benefits to women younger than 50 did not outweigh the health risks associated with false positives in mammograms.

The ACP changed the breast exam guidelines based on the fact that breast cancer is not evenly distributed in women between 40-49. Therefore, “the benefits of screening mammography are not uniformly applicable in women in this age group.” Its guidelines recommended that women and their doctors make the decision for a mammogram on the individual’s family history and the risks associated with mammograms.

Annals, a prominent journal for studies in internal medicine, provides a breakdown of the ACP study.

The National Cancer Institute defines breast cancer as “[c]ancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk).”

After a positive result, a biopsy is performed to determine if the cells are cancerous. During a biopsy, “the doctor removes some cells or tissue, an area of small calcium deposits, or the whole lump.” The National Cancer Institute offers explanations for all possible follow-up tests that could be recommended after a mammogram.

The National Library of Medicine provides an interactive tutorial on breast cancer which covers cancer and its causes, breast anatomy and signs and symptoms. Some symptoms of breast cancer include skin becoming wrinkled and coarse over a tumor as well as discharge from the nipple.