The American Cancer Society, one of the leading cancer groups in the world, is changing its advice on screening mammograms for breast cancer. The ACS now says that most women should start annual screenings at age 45 instead of 40, a change that moves the group closer to guidelines from other health groups.
The ACS is now also advising women that they can switch to getting a mammogram every other year at age 55. Screening every other year after age 55 makes sense because tumors in women after menopause tend to grow more slowly and their breast tissue is less dense, which makes cancer more visible on mammograms
The U.S. Preventive Services Task force has been recommending for some time that women start routine screening for breast cancer at age 50, and then have a mammogram every other year.
Both groups note that these recommendations are for most women, but not all women. The advice is for a woman who is at average risk for breast cancer, not for one who is at greater risk. Doctors generally recommend more intensive screening for higher-risk women. Both groups say a women's preference for when to have mammograms should be taken into consideration.
Mammography is still considered the most effective screening tool for breast cancer, according to Dr. Richard Wender, the cancer society's cancer control chief. But mammograms before age 40 or so, when breast cancer is less common, can lead to a greater number of false alarms.
False alarms are one reason for the change in the ACS's guidance. A false alarm is when an initial result was suspicious but additional scans and sometimes biopsies ruled out cancer. Some younger women are willing to accept the risk of false alarms with mammograms starting at age 40, and that is okay as long as they know those risks.
The ACS started recommending that yearly mammograms start at age 40 in 1997. In 2003, the organization stopped recommending that women examine their own breasts every month.
This update also no longer recommends routine physical breast exams by doctors, saying there's no evidence that these save lives.
The new guidelines were published in the Journal of the American Medical Association.