In 2009, the US Prevention Service Task Force (USPSTF) a government agency, issued new recommendations for mammograms and breast cancer screenings. This controversial new recommendation suggested women younger than 50 without a family history of breast cancer didn’t need an annual mammogram. They also recommended that screening exams for women between 50 and 74 were needed every OTHER year, not annually. This reversed the USPSTF’s 2002 recommendations and went against the American Cancer Society and the American College of Radiology, both of which recommend baseline mammograms at age 35 and annual screenings of ALL women after age 40. There’s also no cut off age, as healthy women in their early to mid 80’s should still have mammograms.
The USPTF’s recommendations to NOT screen before age 50 was based on a study that showed screening 1,330 women over age 50 saved one life but it took 1,904 screening mammograms to save the life of one woman in the 40-50 age group. Hmm. I’m betting that one woman was damn glad she got screened!
The agency also suggested that screening led to false positives which then led to negative biopsies. They implied the biopsies were unnecessary. I don’t know about you, but I’d rather have 4 negative biopsies than 1 positive one. Oh. Wait. I’ve had one of each. And let me tell you, after being diagnosed with breast cancer in 2007, I was relieved my 2008 biopsy was negative.
The thing is, doctors are not going to biopsy women willy nilly. If a doctor recommends a biopsy, it’s because the radiologist saw something suspicious in the breast. It may turn out to be a cyst, lipoma, fibroadenoma, inflammation, or fibrocystic changes. But it could also be cancer. I’m not willing to bet my life on it and I don’t think most informed women would either.
The truth is, doctors have been ordering mammograms since the 1940’s but it wasn’t until the 1990’s that the government (and insurance companies) recognized the need for early detection and the need for screening mammograms. From 1940 to 1990, the death rate from breast cancer remained unchanged. From 1990 to present day, more women are getting screening mammograms and the death rates from breast cancer have decreased by 30%. That in itself says a lot about the need for early detection. Also, breast cancer is usually more aggressive in women younger than 50.
Honestly, I think extending the life expectancy of everyone is a good idea, but it is an especially good idea for women under 50. Early detection saves lives and women in a breast cancer screening program who are diagnosed with breast cancer are more likely to be diagnosed in stage one than women who find a palpable lump. Any woman who has annual clinical breast exams and a mammogram is in a breast screening program. And the program works better if the patient has their mammogram at the same facility each year.
If you decide to change facilities, remember to have your prior mammograms sent to the new facility.
Many doctors have chosen to ignore the US Prevention Service Task Force’s mammogram recommendation. Unfortunately, the task force recently denounced self-breast exams. The agency claimed women didn’t know how to do them and would therefore, stress needlessly if they found a lump that was actually normal glandular tissue. Now imagine how much more stress those women would undergo if they followed the government guidelines and stopped doing self-breast exams and were later diagnosed with breast cancer after the doctor found a palpable lump on clinical breast exam. I’m betting most women would rather find a lump that wasn’t a lump than not find a lump that was cancer.
So please, follow the recommendations of The American Cancer Society, The American College of Radiology, The FDA, and a mammogapher who happens to be a breast cancer survivor. If you are older than 20, do self breast exams. If you are older than 25, have your doctor or medical health provider do a clinical breast exam each year. If you are 35, have a baseline mammogram and then once you turn 40, have a mammogram every year. If you find a lump, have unilateral nipple discharge that is bloody or green, see your doctor. If you have a mother diagnosed with cancer before age 50, subtract 10 years from her age and that is when you should have your first mammogram.
Know your breast. Be informed. And get screened!