Breast cancer is the second leading cause of cancer-related deaths for women in the United States. It is accepted that mammograms (x-rays of the breasts) have helped to reduce the incidence of breast cancer deaths by helping to diagnose breast cancers at earlier stages, when they can be treated more effectively. Between 1999 and 2006, the incidence of breast cancer has decreased 2% each year and the death rate from breast cancer has declined over the last 20 years.
About two years ago, the U.S. Preventive Services Task Force came out with its recommendation that women from ages 40 to 49 should not routinely receive mammograms but that the decision to have a mammogram should be made in consultation with their doctors. The Task Force also recommended that women over 50 have mammograms every other year and stop having mammograms after age 75. The Task Force was made up of 16 health care professionals, none of whom were oncologists (cancer doctors). The proposed recommendations were controversial — many health care providers continued to recommend yearly mammograms for women over 40.
The American College of Obstetricians and Gynecologists (ACOG) had previously recommended that women have mammograms every one or two years beginning at age 40 and every year beginning at age 50.
ACOG has now updated its guidelines so that women should be offered mammograms annually beginning at age 40. ACOG notes that 40,000 U.S. women in their 40s get breast cancer every year, and 20% of those women will die from breast cancer. ACOG’s revised guidelines were based on the number of U.S. breast cancer cases, the speed at which breast cancer grows in young women (for women between 40 and 49, the time between when the breast cancer can be detected by a mammogram and when the cancer grows large enough to cause problems is between 2 and 2.4 years; for women in their 70s , the time is between 4 and 4.1 years), and the potential to reduce breast cancer deaths by using mammograms.
ACOG believes that women in their 40s who have access to mammograms will have a better chance of finding the breast cancer early enough before it spreads. The incidence of breast cancer in women in their 40s is less than the incidence for older women but the time period in which they can be detected before they become problematic is shorter. The five-year survival rate for women whose breast cancer is found early is 98%.
ACOG also recommends that women who are 40 and older should receive an annual clinical breast exam and that women between 20 and 39 should receive a clinical breast exam every one to three years, based on the women’s family histories regarding breast cancer. This recommendation does not replace breast self-examinations.
ACOG’s goals include reducing the death rates due to breast cancer. Nonetheless, the U.S. Preventive Services Task Force presently does not have any plans to revise its recommendations.
How often should you receive mammogram screenings? The best advice is to discuss the matter with your own physician and follow his/her recommendations. If in doubt, get a second opinion from a competent health care provider.
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