New guidelines released by the US Preventive Services Task Force (PSTF) suggest that women should be screened for breast cancer every other year beginning at age 40. This is a change from previous recommendations that women begin testing at age 50, and is more consistent with advice. The American Cancer Society recommends starting mammography already in your 40s.
why shift? New evidence from the National Cancer Institute cited by the PSTF shows breast cancer diagnoses among women in their 40s increased by an average of 2% annually from 2015 to 2019. New guidelines aim to encourage screening at younger ages to save lives.
This updates previous guidance from 2016, when the task force recommended biennial mammography from age 50. The PSTF is a group of independent medical professionals whose recommendations guide physician decisions and influence insurance plans.
“Before 2016, the standard recommendation was to have an annual mammogram beginning at age 40,” explains Matt Miller, PhD, a radiologist who specializes in breast imaging at Allegheny Health Network (AHN). “Then they decided to recommend it every other year, which is kind of jumpy in the face of all the data out there. It was a big campaign for us, the people, to put an end to this mess and be able to say, “No, the data is still 40.” ”
Breast cancer is the second most common cancer among women in the United States. Regular breast cancer screenings include a mammogram, an x-ray of her breasts that is the first line of defense against breast cancer. The recommendations were aimed at people at average risk of breast cancer, and the new guidance highlights the benefits of annual testing, including the risk of unnecessary testing and false positives that can lead to emotional stress. outweigh the potential harm.
Although this change helps bring all parties together on the message of starting mammography at age 40, there is still some disagreement. “Now every organization is again recommending starting at her 40s, so there’s no more confusion about when to start,” Miller says. “The problem is that this was a big step, but it was an imperfect step because they still said they would do it every other year.”
This is in contrast to many other organizations recommending annual mammograms. “Yes, they even say that doing it every other year saves the most lives, but we think we just need to do it every other year,” Miller said. “They say they don’t want so many false positives. If you’ve had a screening mammogram and been recalled, it doesn’t necessarily mean you’ve had a biopsy, but an additional imaging test.” I think it would be wrong to try to limit it at the expense of detecting more cancers.”
Miller knows how tests and diagnoses can wreak havoc on your emotions. His own wife is a breast cancer survivor and she was just diagnosed with breast cancer when he was 29 years old. “She’s fine. She’s totally fine,” he said. “But for me, I want to know that they are getting the most appropriate care. Well, you might see something that isn’t really cancer, and that’s okay. Know that the people watching the breast are doing exactly what they need to detect the most cancers and save the most lives.”
While Miller is happy that the new guidelines will bring the age down again, he hopes the task force will go a step further and recommend annual rather than biennial mammography screenings.
“Our work isn’t done because we have to make sure no one reads this and thinks they should do it every other year,” Miller said. “There’s a big difference between one year and two years as the cancer can grow and get worse. Talk to your doctor, but the safest advice is to do it every year.”
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