New Guidelines Say Many Women Under 50 Can Skip Mammograms. That May Not Be The Best Advice

The ACP recommendations, published by the Annals of Internal Medicine, reports that “clinicians should offer biennial mammography to screen for breast cancer in asymptomatic average-risk women aged 50-74 years.” But age 50 is a lot later than the recommended age to begin screening.

Currently, The American Cancer Society recommends that women be given the option to begin annual mammograms at age 40 and that all women, regardless of risk factors, start annual mammograms at age 45.

“What I’m most concerned about is the women who haven’t been in for a mammogram for two, three, or four years, those women that have never had a mammogram,” says Dr. Connie Lehman, Chief of Breast Imaging Division at Massachusetts General Hospital. “We all agree regular screening mammography saves lives. Every doctor that I know, every organization that I know really encourages women to have a mammogram.”

Dr. Connie Lehman on the importance of mammogram screening for breast cancer

“One of the most frustrating things I see in my office and in my practice, is when a patient, and African American patients included, come in with a huge golf ball breast cancer, that could have probably been diagnosed at an earlier age, if they were receiving annual screening mammograms,” says Dr. Senyat Agonafer, Radiologist at Lenox Hill Radiology focused on screening breast cancer, and diagnostic breast cancer.

Dr. Senyat Agonofer on recommended mammography and screening for breast cancer

The new ACP recommendations go on to say that patients and clinicians should discuss their options with their doctor if they are under age 50: “Further, clinicians should discuss whether to screen with mammography in average-risk women aged 40-49 years and consider potential harms and benefits.”

The debate over when women should begin getting mammograms has been ongoing, and often confusing to women trying to make healthcare and prevention decisions. There had been widespread consensus that women should have annual mammograms between the ages of 45 and 54, and patients can opt to have mammograms every two years after menopause, around age 55.

But there is some disagreement among doctors as to whether mammograms are beneficial for women between the ages of 40 and 45. This is an option you should of course discuss with your own doctor.

“We start at the age of 40, and we do screening mammography annually. For patients who are higher risk, we also recommend screening with breast MRI,” says Dr. Agonafer.

And in some cases, you may need extra screening. “For patients who have dense breasts, which means that there is more breast tissue on the mammogram than there is fat, we actually also recommend screening with ultrasound, the reason being that mammography is about 15 to 20 percent less sensitive in patients with dense breasts.”

There is even some debate over whether women should get mammograms beginning at a much younger age. In a 2018 study, researchers analyzed data from 5 million different mammograms, and concluded that it may be beneficial for some women with risk factors to begin screening at age 30.

 

 

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