When Should Women Start Getting A Mammogram: New Guidelines Released

ATLANTA - Should you still get that yearly mammogram?  New recommendations from the US Preventive Services Task Force may have younger women reconsidering their options.

The US Preventive Services Task Force (USPSTF) released its final breast cancer screening recommendations late Monday afternoon.   This comes after months of debate over when women should begin getting screened, and how often they need to be screened.

The Task Force considered more than 5 years of science on breast cancer screening weighing the benefits and harm of mammography in different age groups of women.

The USPSTF says women between the ages of 50 and 74 experience the best balance of benefits versus risks. 

But, women in their forties are more likely to experience the potential harms of getting yearly mammograms.

One big one downside? Younger women are more likely to have dense breast tissue, which is harder to screen.  This can lead to “false-positive” test results.  That happens when a radiologist sees something suspicious on a woman’s breast x-rays, so the woman is called back for another mammogram, ultrasound or MRI. 

Often, follow up screenings show the woman’s breast tissue is normal.   But the USPSTF says those false-positives can lead to unnecessary anxiety, stress and treatment women may not need.

For average-risk women in their forties, the Task Force says screening mammography every two years can be effective in reducing the number of breast cancer deaths.  

It recommends women decide with their doctors whether to be screened in their forties, or wait until they reach 50, based on their health history.

The Task Force recommendations by age:

From 40-49: Women should decide with their doctor on when to begin getting a mammogram.

From 50-74: Women should be screened every other year.

75 and older: No recommendations.  The Task Force says there in insufficient science to recommend for or against continuing mammography after age 75.

The American Cancer Society and several other medical professional organizations recommend average-risk women start the screenings at 40 and get a mammogram each year.

At Grady Memorial Hospital, breast cancer surgeon Dr. Sheryl Gabram, Director of the Avon Comprehensive Breast Cancer Center, says she will continue to recommend mammograms from age 40 on for “average-risk” women.

Dr. Gabram says screening women in their forties saves lives by catching cancers early, when they’re much easier to treat.

 “Remember that the United States Preventive Services Task Force is not recommending against screening,” Dr. Gabram says. “They're just saying it's an individual choice in the forties.  Both the Task Force and the American Cancer Society really say that you can save the most lives by starting screening in the 40's, and that's for women of average risk.”

So what should women do?

“I think what women should do is talk to their doctor,” says Dr. Gabram.  “But they should also recommend that the American College of Radiology, the Society of Breast Imaging and the American College of Obstetrics and Gynecology are all recommending screening starting at 40 on an annual basis."

Dr. Gabram says she worries women may be confused by all the mixed messages, or they may think they don’t really need to get screened.

"So, that is what I'm very concerned about, is that women will often say, 'Okay, fine. We'll just put this off. I have other things to do with my family,’” Gabram says, "When, in fact, we can save the most lives with breast cancer if we start screenings in the forties."

The new guidelines should not affect your health insurance coverage, because the Task Force does not make recommendations for or against insurance coverage.