What are the guidelines for breast cancer screening?

Dr. Amanda J. Morehouse, MD
Critical Care Surgeon

Recommended breast cancer screenings and frequency of screenings vary based on a variety of factors, including a woman’s age and family history. For example, it is recommended that all women between the ages of 45 and 54 schedule an annual mammogram. However, beginning at age 55 mammograms are recommended only every other year. For younger women who are between the ages of 40 and 44, most experts would suggest that patients should practice caution and seek their primary care physician’s guidance. At any age, breast cancer treatments are more effective when identified at the earliest stage of development.

Genetics is a significant determinant of when and how often a woman should receive her annual mammogram. Most oncologists suggest that in situations where there is a family history of breast cancer, screenings should begin at minimum 10 years prior to the age of the youngest family member who was diagnosed. Please note that in the case of a genetic mediated cancer, the age that screenings should begin will be based on the type of gene and the breast surgeon’s recommendation.

Dr. Randolph P. Martin, MD
Cardiologist (Heart Specialist)

The American College of Obstetricians and Gynecologists (ACOG) released new guidelines advocating for more frequent screening intervals for breast cancer detection. ACOG recommends that women begin having yearly mammograms at age 40. In contrast, the U.S. Preventative Services Task Force (USPSTF) recommended in 2009 that no mammography was needed for low-risk women ages 40 to 50, instead recommending that women receive mammograms every other year beginning at age 50.

With so many different screening recommendations, it can be confusing for women. As a Fellow of the ACOG, I am proud that they are advocating for early detection. Nearly 75 percent of women diagnosed with breast cancer are not high-risk and to only screen high-risk women ages 40 to 50 would miss many cases of cancer. Screening mammography has contributed to a reduction in fatal breast cancer cases. In fact, breast cancer diagnosed in younger women is often more aggressive and fatal, so early detection is crucial.

It is also very important for women to be aware of their individual risk for breast cancer. They may be candidates for BRCA1 or BRCA2 gene testing, which might suggest more extensive screening that could lead to early detection.

Overall, I believe women want as much preventive medicine as we can give them. Every woman should discuss preventive care with their OB/GYN at their annual well-woman exam.

The national cancer advisory organizations sometimes do not agree about specific cancer guidelines, often making it confusing to the public about what to do. That is why you should err on the side of caution by always consulting a healthcare professional to help advise you about what to do, given your personal family health history.

The United States Preventive Services Task Force (USPSTF) recommends that all women ages 40-50 consult with their doctor to decide if screening is appropriate. USPSTF guidelines also recommend that women begin routine screening for breast cancer with mammography at age 50. This is the guideline that most women should follow, as it is largely based on medical evidence that screening will result in more good than harm.

Other guidelines differ. Patients should discuss their risk for breast cancer and the possible benefits and uncertainties of screening with their doctor before being screened.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.