At what age and how often should you have a mammogram?
By Roberta Cannon, RN

 
Just when you thought you knew the official recommendation on when you should be getting a mammogram, another update comes along. This time it’s the United States Preventive Services Task Force (USPSTF), which recently announced that women should begin their breast cancer screenings at age 40 and have a mammogram every other year.

While the USPSTF is updating their breast cancer screening guidelines to make them more in line with the other groups discussed in an Oct. 22 story: “At What Age Should You Screen for Breast Cancer?”, they are not completely in sync yet.

“The Task Force previously recommended that women should be screened every other year from age 50 to 74,” said Jill Oxley, MD, FACS, a breast cancer surgeon based at Cuda Breast Care Center in Hyannis and director of Breast Services for Cape Cod Healthcare. “Now they recommend that women start getting screened every other year beginning at age 40. This is a step toward their recommendations being more in line with other groups.”

Cape Cod Health News last spoke with Dr. Oxley in October 2022, when the National Comprehensive Cancer Network (NCCN) published their updated guidelines for patients regarding breast cancer screening, which stated that women should undergo a breast cancer risk assessment at age 25 and those with average risk should begin annual mammography starting at age 40.
At that time, Dr. Oxley noted the NCCN changes to their guidelines were not new, but they had revised theirs to fit other guidelines that had been around for a while.

A Long List

“One of my pet peeves is how many different guidelines there are,” she said.
The list is long when it comes to organizations that have guidelines for screenings.

There is the NCCN, American Society of Breast Surgeons (ASBrS), the American College of Radiology (ACR), The American College of Obstetricians and Gynecologists (ACOG), the Society of Breast Imaging (SBI), and the American Cancer Society (ACS) .

“All these groups agree on annual screening beginning at age 40,” said Dr. Oxley. “The breast imagers and breast surgeons also recommend a formal risk assessment by age 25 to 30. These guidelines are for women with an average risk of breast cancer.”

While the USPSTF is more in line with the other groups, they also called for more research.

“They are calling for more research but there are lots of studies that show that screening mammography improves the survival rate for all women, especially between the ages of 40 to 49,” said Dr. Oxley. “One-sixth of all breast cancers are diagnosed in women in their 40s. One-quarter of breast cancers diagnosed in white women are under the age of 50 whereas one-third of breast cancers diagnosed in black, Hispanic, and Asian women are under the age of 50.”
​
The Takeaway

“The bottom line is that all the other groups have recommended screenings every year starting at age 40,” said Dr. Oxley. “I, our Breast Care Center, and our Cape Cod Healthcare breast radiologists recommend that women who are at average risk for breast cancer start screening at age 40 and continue as long they are in good health with a life expectancy of at least 10 years,” said Dr. Oxley. “Every woman should have a risk assessment done between the ages of 25 and 30, especially women of Black, Hispanic, or Asian origin because they may benefit from earlier or supplemental screening.”
Originally published on Cape Cod Health News, May 23, 2023