Rethinking Mammograms

Rethinking Mammograms

by Susan Neuhalfen

Most women are told that starting an age 40, they need to start scheduling annual mammograms. However, many different medical entities now disagree not only on when women should start scheduling mammograms but how often they should have one.

Mammograms are low frequency x-rays of the breasts used for diagnosis and screening. They are responsible for the early detection of breast cancer in many women and have saved countless lives.  However, some medical entities argue that we don’t need to be conducting as many mammograms over a woman’s lifetime as we are. Here are some of the latest recommendations:

  • The U.S. Preventative Services Task Force recommends that mammography screening for most women start at age 50 rather than 40, and that the frequency be every two years (instead of annually) through the age of 74.
  • American College of Physicians also recommended raising the age to 50.
  • American Cancer society recommends women start mammography at 45, that they undergo annual mammograms from 45 – 54, and continue to undergo mammography every other year after that.

Now a new debate has been fueled that argues that for every death prevented, there are three to four women “over-diagnosed”. That means that the mammogram pinpointed a suspicious area that required extra tests or a biopsy, but turned out not to be cancer. Good, right? Well…according to the study, this causes the patient stress and anxiety as well as additional medical costs. The “false positives” as they are called, can, in some cases, do more harm than good according to these folks.

Let’s check the facts.
In a research study published in the journal Cancer in 2017, three different groups of women were assessed:

  • Group 1 – participants had a mammogram every year from age 40 to age 84.
  • Group 2 – participants had a mammogram every year from age 45 to age 54, then mammograms every other year from age 55 to age 79.
  • Group 3 – had a mammogram every other year from age 50 to age 74.

Here is what the study found:

  • Group 1  – annual screening reduced mortality by 39.6%.
  • Group 2 –  scheduled screenings reduced mortality by 30.8%.
  • Group 3 –  scheduled screenings reduced mortality by 23.2%.
  • For those wondering about the false positives, although there a larger number of mammograms conducted from Group 1 to Group 3, the number of false positives for each group hovered roughly around 8%.

If the goal is to prevent the most deaths from breast cancer, the annual mammogram starting at age 40 is the best bet for all women according to this study.  Here are some other things that are important to prevent breast cancer:

  • Know your family history – have a talk with your family about medical conditions. If other members of your family have had breast cancer, you, too are at greater risk.
  • Keep a healthy lifestyle – obesity, smoking, excessive alcohol use (1-2 drinks/ day), and an unhealthy diet (refined foods, meats, saturated fats, sugars) all contribute to breast cancer.
  • Perform breast self-exams in the shower.
  • Keep to your regular OB/GYN exams as well as scheduled mammograms.

The best thing to do is to consult your doctor about your risks and what he or she believes is the best path forward.

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