April 11, 2019

Most women can get mammograms every other year starting at age 50

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Women who are not at high risk for breast cancer can wait to start getting mammograms until age 50 and be screened every other year, according to new guidelines from the American College of Physicians.

Women at high risk for breast cancer are those with a family history of breast cancer, previous cancer scares, dense breast tissue, or genetic mutations linked to breast malignancies. The new guidelines were recently published in the Annals of Internal Medicine recognize that most women aren’t at high risk and don’t need mammograms before 50 or annual screening.

The goal of screening mammography is to detect tumors before they can be felt in a physical breast exam, catching cancer sooner when it’s easier to treat. Ideally, this should mean fewer women are diagnosed when tumors are bigger, rapidly growing, and harder to attack.

But screening too early or too often can also catch more small, slow-growing tumors that are unlikely to be fatal – without curbing the diagnosis of advanced cancer cases, some previous research suggests. Harms of too much screening can include unnecessary invasive follow-up tests and cancer treatments for tumors that never would have made women sick or led to death, also called overdiagnosis.

For most women 40 to 49 years old, the potential harms of screening mammograms outweigh the possible benefits, according to the ACP guidelines.  Once women start getting mammograms, they should continue through age 74, the ACP recommends. After 75, or earlier for women with a life expectancy of 10 years or less, screening mammograms should stop, according to the ACP.

The American Cancer Society, however, says women ages 45 to 54 should get mammograms every year. Starting at 55, women can continue annual screening or switch to getting mammograms every other year, the cancer society advises.

Reference:  bit.ly/2OpPUY2 Annals of Internal Medicine, online April 8, 2019.

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