Breast Cancer Screening: Know Before You Go

By Kari Bohlke, ScD

In 2009 the US Preventive Services Tasks Force (USPSTF) changed its position on routine screening mammography for average-risk women in their forties. The new recommendations suggested that routine screening mammography start at age 50 and that decisions about screening mammography in younger women be made on an individual basis.1 In response the American Cancer Society stated that it would continue to recommend annual mammograms starting at age 40.2

The ensuing public debate reflected the ongoing conversation in the medical community about the value of routine screening mammography for women in their forties. The focus of the debate is the balance of risks and benefits, which is likely to vary by age. The most important potential benefit of screening mammography is a modest reduction in breast cancer mortality. Potential risks of mammography include false-positive test results (which lead to stress and additional testing), false-negative test results (a missed cancer), and overdiagnosis (diagnosis of a cancer that will never cause health problems during the life of a patient). Younger women are more likely than older women to experience some of the downsides of mammographic screening and are less likely to have breast cancer.

That fact that the USPSTF and the American Cancer Society have different screening recommendations for women in their forties simply reinforces the importance of educating yourself about the potential risks and benefits of screening, talking with your physician, and making the decision that’s right for your unique situation. Women at increased risk as a result of family or personal history, for example, may need to begin screening at a younger age and may benefit from screening with breast magnetic resonance imaging (MRI) in addition to mammography.

All women who have questions about the screening schedule and the approach that’s right for them are advised to talk with their physician.

To view the USPSTF guidelines, visit www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm.

To view the ACS guidelines, visit www.cancer.org/Healthy/FindCancerEarly/CancerScreeningGuidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.

References

1. US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine. 2009;151:716-26.

2. American Cancer Society Responds to Changes to USPSTF Mammography Guidelines. American Cancer Society website. Available at: http://ww3.cancer.org/docroot/MED/content/MED_2_1x_American_Cancer_Society_Responds_to_Changes_to_USPSTF_Mammography_Guidelines.asp.  Accessed April 7, 2011.