An Update on Mammography
In October, Eureka posted a series of roundtable discussions, including one about the multiple guidelines and conflicting data surrounding routine mammography screening. Soon after, the American Cancer Society (ACS)—one of the earliest and most ardent supporters of yearly mammograms—announced that it was easing its longstanding guidelines, which were published in the Journal of the American Medical Association.
In a nutshell the updated guidelines recommend:
- Women with average risk of breast cancer should under regular screenings starting at age 45 (the previous guidelines recommended annual mammograms for women 40 and older) and that women ages 45-52 should be screened annually
- Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually
- Women should continue routine screening as long as their overall health is good and have a life expectancy of 10 years of longer
- Against clinical breast exams for breast cancer screening for average-risk women of any age
What should one make of these shifting positions? We asked Emily Hickey, corporate senior vice president of Discovery at Charles River who participated in our recent roundtable. She noted immediately that the ACS guidelines were still somewhat in contrast to what the US Preventive Services Task Force recommended earlier this year (but hasn't yet finalized.) That panel said:
- Routine screening of average-risk women should begin at age 50, instead of age 40
- Women should get screening mammograms every two years instead of every year
- Routine screening should end at age 74
- Breast self-exams have little value, based on findings from several large studies
Dr Diana B. Petitti, MD, vice-chair of the Task Force's, noted however that their updated guidelines don't apply to women with moderate to high risk of breast cancer, such as having BRCA mutations or a close family history of the disease. Nor do they mean that average-risk women who are younger than 50 or older than 74 should never be screened. "A woman who still wants to be screened after having the conversation with her clinician and considering the balance of benefits and harms should absolutely be screened," Petitti says.
In the end, says Hickey, this is a personal decision to be discussed with your doctor to truly weigh the risks and benefits of this procedure.