The American Cancer Society (ACS) recommendations, which were updated in October 2015, specify that women aged 45-54 who are at average risk should undergo yearly mammograms, and every two years for women age 55 and older. Women age 40-44, the ACS says, should have the option to start annual mammograms if they chose to do so.
However, the U.S. Preventive Services Task Force recommends that average risk women begin mammograms at age 50, and continue every two years until age 74. The guidelines, which were updated in January 2016, provide some flexibility for women age 40-49, leaving the decision to the individual doctor and patient and emphasizing the importance of patient preference.
“While either approach is reasonable, the Dana-Farber/Brigham and Women’s Breast Program endorses the ACS recommendations,” says Eric Winer, MD, director of the Breast Oncology Program at the Susan F. Smith Center for Women’s Cancers at Dana-Farber. “But again, we must highlight the importance of the individual doctor and patient discussion regarding a woman’s risk of breast cancer and the risks and benefits of screening.”
What both the ACS and the U.S. Preventive Services Task Force recommendations agree on is the importance of individualized treatment and the ability for women to begin screening at age 40 if they and their doctor feel it will help reduce their risk for developing breast cancer.
“In general, women at increased risk should begin screening at 40 (or earlier in some cases) and should be having annual mammograms,” Winer says.
“Besides the well-known cancer-susceptibility genes BRCA1 and BRCA2, inherited abnormalities in an array of other genes can also raise breast cancer risk. Women who have had certain benign breast conditions may be at an increased risk as well, as may women with a family history of breast cancer. Women with gene mutations that predispose them to breast cancer typically begin regular screening at an early age, which usually involves breast MRI in addition to mammography. For other women who are at high risk, routine screening mammography may not be sufficient, and other approaches, including MRI screening, are being studied.”
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