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Mammogram: When should I start getting mammograms and how often should I have one?

The U.S. Pre­ven­tive Ser­vices Task Force (USPSTF) is a group of health experts that reviews pub­lished research and makes rec­om­men­da­tions about pre­ven­tive health care. The USPSTF has issued new mam­mo­gram guide­lines. These rec­om­men­da­tions include:

* Screen­ing mam­mo­grams should be done every two years begin­ning at age 50 for women at aver­age risk of breast can­cer.
* Doc­tors should not teach women to do breast self-exams.
* There is insuf­fi­cient evi­dence that mam­mo­gram screen­ing is effec­tive for women age 75 and older, so it’s not rec­om­mended for this age group.

Dif­fer­ing mam­mo­gram guide­lines

breast exam

mam­mo­gram

Mean­time, the ACS says the breast self-exam is optional in breast can­cer screen­ing.

Accord­ing to the USPSTF, women who have screen­ing mam­mo­grams die of breast can­cer less fre­quently than do women who don’t get mam­mo­grams. How­ever, the USPSTF says the ben­e­fits of screen­ing mam­mo­grams don’t out­weigh the harms for women ages 40 to 49. Poten­tial harms may include false-positive results that lead to unneeded breast biop­sies and accom­pa­ny­ing anx­i­ety and distress.

A three-tiered approach is used which includes:

* Breast self-exam to iden­tify breast abnor­mal­i­ties and allow a woman to become famil­iar with her breasts so that she can tell her doc­tor about any changes
* Clin­i­cal breast exam per­formed by a health care provider and rec­om­mended annu­ally begin­ning at age 40
* Screen­ing mam­mog­ra­phy begin­ning at age 40

Screen­ing mam­mo­grams have detected abnor­mal­i­ties in women in their 40s. These women have then had biop­sies and learned they had inva­sive breast can­cer. There are many sto­ries about younger women who have found can­cer early as a result of screen­ing. And it’s impor­tant to remem­ber that most women who get breast can­cer have no fam­ily his­tory or other risk fac­tors for the dis­ease.

Screen­ing mam­mog­ra­phy is not a per­fect exam. There will be a lot of new data pub­lished in the com­ing months, and it will take time to ana­lyze the results and see what infor­ma­tion can be gained to deter­mine how best to use mam­mog­ra­phy as a screen­ing tool.

In the mean­time, women should meet with their health care providers to dis­cuss the ben­e­fits, risks and lim­i­ta­tions of screen­ing mam­mo­grams. If you’re con­cerned about screen­ing mam­mo­grams, talk to your doc­tor and learn what’s right for you based on your indi­vid­ual risks. It’s impor­tant that the two of you work together to develop a screen­ing plan.

from Sand­hya Pruthi, M.D.

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