Mammograms Standards

A radiologist uses a magnifying glass to check mammograms for breast cancer May 6, 2010, in Los Angeles.

Should I get my first mammogram at age 40, 45 or 50? Should I get one every year or every two years? At what age should I stop getting them?

The recommendations for screening mammography are both confusing and contradictory. Many medical professionals recommend annual screening mammograms starting at age 40. But the United States Preventative Services Task Force has recommended that women only get mammograms from ages 50 to 74, and only get them every other year. They even suggest that women should not perform breast self-examinations.

I could not disagree more with their ill-advised recommendations. Here are some facts:

Annual mammography starting at age 40 has been shown to decrease deaths from breast cancer by up to 40%.

One in six breast cancers occur in women between the ages of 40 and 49. The most years of life are saved by screening mammograms performed on women in their 40s.

Annual screening mammography finds more cancers and finds smaller cancers that have a higher cure rate and require less invasive surgery and therapy.

One study suggests that if the United States Preventative Services Task Force recommendations were implemented, 6,500 to 10,000 women would die of breast cancer in this country each year that would otherwise have been saved. Virtually all studies have consistently shown that mammography saves lives. And most of these studies are based on older technology including lower resolution film-screen mammography and older 2D digital mammography.

3D mammography can increase the detection of cancers by 50%. This technology is helping us to see cancers in dense breast tissue that were impossible to see previously. Recent improvements in breast sonography have also enhanced our ability to see early cancers.

So, if older technology is saving the lives of 40% of women who would have otherwise died of breast cancer, imagine how many more lives we are saving with our current technology. Women should reject the task force recommendations and instead follow the recommendations of breast surgeons and breast imaging specialists.

A woman at average risk of breast cancer should get a 3D mammogram at age 40 and every year after that as long as she is in good health. Women with increased risk of breast cancer should discuss additional screening tests with their health care providers.

Steven Clifford, M.D., is a diagnostic radiologist specializing in breast imaging. He works at Solis Mammography of Paris.

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