At What Age Should A Mammogram Be Taken?
When Should I Have a Mammogram?
Breast cancer is one of the most frequently diagnosed cancers in the world.
This Therefore, doctors encourage patients to have mammograms where they can identify problems before their symptoms appear.
However, the various health organizations that set out mammogram guidelines and recommendations do not agree on how early or how often women should be tested.
The American College of Physicians (ACP) has updated its screening guidelines to recommend people at an average risk for breast cancer (that is, those with no personal or family history of breast cancer, those with dense breast tissue or genes that may increase their risk of breast cancer).
Starting at age 50, women should have a mammogram every year. Women between the ages of 40 and 49 should discuss the risks and benefits of the screening procedure with a doctor.
Previously, ACP had set the start date of mammography at age 40 for women without risk factors.
This update puts the organization in line with the U.S. Preventive Services Task Force, which says regular mammograms should begin at age 50, with a choice between 40 and 49.
On the other hand, the American College of Obstetricians and Gynecologists recommends annual screenings starting at age 40, as does the American College of Radiology. The American Cancer Society is taking a hybrid approach and says people can start getting mammograms at age 40 if they want, instead of when women are 45.
As with all screening tests, recommendations for mammography require a complex balance between the benefits of testing and the drawbacks of overtesting, as the emotional damage of false positive cancer results or providing unnecessary treatments for small tumors that may never be found can become dangerous.
People under age 49 are more likely to need follow-up screening, partly because their breasts are denser, making scans more difficult, says Linda Moy, NYU School of Medicine Professor of Radiology. They’re also more likely to have false-positive scans that raise concerns.
Offering screening from age 50 means prioritizing the reduction of these additional testing and overdiagnosis, and examining the question from the societal, public health level: limiting the amount spent on testing without sacrificing care that reaches the greatest number of people.
According to research from the New England Journal of Medicine, mammography scans, which are done to monitor healthy people and not to look for symptoms, are more likely to lead to overdiagnosis than early detection of a dangerous tumor.
In particular, mammogram scans have increased the number of cases of a non-invasive breast cancer called Ductal Carcinoma in situ (DCIS), which includes cells that line the breasts’ milk ducts but rarely spread beyond.
Screening tests were less able to detect the early stages of other types of breast tumors that have the potential to metastasize and be fatal.
But Moy thinks the priority should be to get as much luck as possible, even if it generates more false alarms, and says screenings should start at age 40.
“We want to find cancers when we are little. We need to call patients back because we want to be sure,” she says. That said, monitoring won’t lead to minimizing anxiety, but the level of anxiety can vary from patient to patient, he says.
Physicians who follow these guidelines typically follow the recommendations of their professional community, Moy says: Radiologists follow the guidelines of the American College of Radiology, and gynecologists follow those from the American Congress of Obstetricians and Gynecologists.
A 2017 study found that more than 80 percent of primary care physicians and gynecologists said their patients should start mammograms at age 40.
However, doctors who said they trusted the U.S. Preventive Services Task Force recommendations were least likely to recommend starting screening. At age 40, he states that medical body guidelines play a role in the way doctors advise their patients.
Moy stated that many physicians recommend their recommendations on a patient basis. “There are discussions about mammograms, they’ve been very effective in diagnosing cancer before, but they can also have false positives, what do you want to do?” They may say.
After all, it’s good to have that dialogue and make patient-based decisions. “We don’t want to be dogmatic. Doctors know their patients and understand their history,” he says. “We try to be flexible.”
Source: Popsci.com, You might not need a mammogram until you turn 50, 2019.