Currently, mammography is recommended starting at age 40. Should I take it?

CNN
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The U.S. Preventive Services Task Force, an influential group of medical experts, Recommended last week Most women begin having mammograms at age 40. Women should continue to have mammograms every other year to screen for breast cancer until they are 74 years old, the task force said.

This is a notable difference from the task force's previous guidance to begin biennial mammography by age 50. Women in their 40s were advised to make individual decisions with their health care provider, but there was no clear recommendation to start mammography every two years. They turned 50 years old.

I wanted to know more about why these changes were made. Who should follow this updated guidance? Are there women who need to be tested earlier or more often? What tests other than mammography are needed? And to reduce the risk of developing breast cancer? Are there any precautions that can be taken?

To answer these questions, we spoke to CNN wellness expert Dr. Leena Wen. Wen is an emergency physician, and George is an adjunct associate professor at the University of Washington. She previously served as the health commissioner for the city of Baltimore.

CNN: How common is breast cancer?

AS Dr. Liana Wen: In the United States, breast cancer second most common cancer It is the second leading cause of cancer death in women. According to the American Cancer Society, one in eight women will be diagnosed with invasive breast cancer during their lifetime.about 42,000 women People die every year from this cancer.

It is important that women know their risk factors and get tested accordingly. By definition, screening occurs before symptoms appear. Screening helps detect cancer at an early stage, before it spreads, when treatment is most likely to be successful.

CNN: Why did the U.S. Prevention Task Force make this change?

Wen: recent years, disturbing trend Cancer diagnoses are increasing among young people. This applies not only to breast cancer but also to colon cancer.

In fact, breast cancer is the most common cancer and the leading cause of cancer death in women. 20～49. Younger women tend to have more aggressive cancers at the time of diagnosis than older women.

This is especially true for black women. According to a 2023 study, the breast cancer death rate for black women in their 40s was 27 per 100,000 person-years compared to 15 per 100,000 person-years for white women. JAMA network open study.

According to a study published in the journal lancet oncologystarting mammography as early as age 40 may reduce breast cancer mortality rates.

of Changes to the U.S. Prevention Task Force Its recommendations are now closer to those of other major national bodies.of American College of Obstetricians and GynecologistsFor example, it is recommended that screening begin every 1 to 2 years starting at age 40 and continuing until at least age 75. American Cancer Society Women ages 40 to 44 are given the option of getting a mammogram every year, and women ages 44 and 55 are encouraged to get a mammogram every year. (If you are 55 years or older, you can switch to every other year or continue having mammograms once a year.)

CNN: Who should follow this updated guidance?

Wen: We encourage women to be aware of this updated guidance and discuss it with their doctors. Importantly, this guidance is aimed at women with average breast cancer risk. People at average risk should start getting mammograms by age 40.

This guidance does not apply to people at high risk. Everyone should assess their own risk to see if they are at increased risk. In that case, additional testing may be needed more frequently than these recommendations.

The updated guidance also applies to anyone assigned female at birth. This includes not only cisgender women; transgender men and non-binary people. These people should talk to their health care provider to assess their risk factors and therefore how often they should be screened.

CNN: How can people decide whether they need to be tested more often or earlier in their lives?

Wen: The most important factor is your personal or family history of breast cancer. People who have had breast cancer themselves should talk to their oncologist or primary care provider to find out what tests they need and how often to monitor for cancer recurrence. The same is true for people who have previously had radiation to their chest for other cancers.

Family history is also an important determinant of risk. Women who have a sister, mother, or other first-degree relative with breast cancer may average risk doubles About breast cancer. A woman with two first-degree relatives has five times the risk of developing breast cancer.

CNN: What should women expect from their first mammogram?

Wen: Mammography is an X-ray examination of the breasts. Typically, your technician will take you to a room where you will remove your bra and shirt, wipe away any deodorant in your armpit area that could interfere with your results, and change into a gown that covers you from the waist up. (You don't need to take off your underwear, pants, or shoes). You will then be guided to the mammography machine. The technician will position the machine to best capture images of your breasts.

The part of a mammogram that can cause discomfort is when the technician places the breast between two plastic imaging plates and applies pressure while the image is taken. However, the discomfort usually disappears within a few seconds. If you're concerned about potential discomfort, consider taking Tylenol or ibuprofen an hour before her mammogram.

CNN: What tests besides mammograms might be needed?

Wen: Genetic testing may be recommended for people with a family history of breast cancer. They and other people at higher than average risk for breast cancer may need to start mammograms at an earlier age or have mammograms at more frequent intervals. Other tests may be used along with the mammogram. These include breast ultrasound, breast MRI, or both.

has an average risk, but dense breast tissue. Mammography remains the screening test of choice for these women, but additional imaging may be needed to more accurately look for possible masses.

of American College of RadiologyFor example, we recommend breast MRI for some women who are at moderate risk but have dense breast tissue. Although the U.S. Preventive Services Task Force has not made this recommendation, it has implications for insurance coverage of imaging. Anyone who is very concerned about their risk of breast cancer should definitely discuss this situation with their doctor. Your doctor can help you decide what's best based on your personal and family medical history and whether it's worth the extra cost.

CNN: What about women over 74? Why should they stop getting breast cancer screenings?

Wen: The U.S. Preventive Services Task Force concluded that there is insufficient evidence to recommend whether or not to recommend mammography for women age 75 and older. However, other major medical societies continue to recommend mammography for people age 75 and older, especially those who are generally healthy and have a long life expectancy. This is, once again, an issue that should be discussed with the individual healthcare provider, who can take into account other aspects of health and the patient's wishes.

CNN: Are there steps young people can take to reduce their risk of cancer?

Wen: Risk factors for developing breast cancer include smoking and heavy alcohol consumption, so quitting smoking and reducing alcohol consumption can help reduce your risk. According to research, exercise Increasing your intake of whole foods, as well as reducing your intake, can lower your risk of cancer in general. super processed material.

Women should also seek care if they develop symptoms. If you have any worrisome symptomsA new lump or lump in the breast or armpit, red or flaky skin on the breast, nipple discharge other than breast milk, or pain or swelling anywhere in the breast.

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