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Reducing The Breast Cancer Risk: Are Mammograms Still Best? And When Should You Start?

By Danielle Sullivan |

breast cancer, mammography, mri, breast cancer prevention month, breast cancer awareness

There are so many strides being made in early detection, does it make sense to rely so heavily on the mammogram?

When will you have your first mammogram? It seems every doctor has a different opinion, not only on when women should start having mammograms but also if mammograms are the best way to go in the detection of breast cancer.

The U.S. Preventive Services Task Force (USPSTF) threw the medical community into a stir two years ago, when in 2009 they changed their breast cancer scanning guidelines – recommending that screening begin at age 50 and even then, only every other year until age 75. The new guidelines, recommend “against routine screening mammography in women aged 40-49 years” as well as “concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older.” The USPSTF says this protocol is based on women of average risk.

This single recommendation caused fury in the medical world because many believe that the recommendation was based on cost-effectiveness rather than the early detection of almost 14,000 women aged 40 to 49  (below their supposed screening age) who are diagnosed with breast cancer each year.

But what if your doctor recommends much earlier scanning, as many doctors do? And what scans should every woman get? When should they start?

The American Cancer Society and many breast cancer centers continue to recommend annual mammograms starting at 40.

“Women with no family history should get their first mammogram at 40 and then every other year until they reach 50”, says radiologist Dr. Steven Mendelsohn, Medical Director at New York’s Zwanger Pesiri Radiology. At age 50, he says they should seek an annual mammogram.

While Dr. Abraham Port, Medical Director at Complete Women’s Imaging in New York says that while he agrees that all women should obtain a mammogram beginning at age 40, he says a woman should have an annual mammogram after age 40, with a baseline mammogram performed somewhere between the ages of 35 and 40.

But are mammograms enough? Mammograms have a well-known, two-folded shortcoming: they produce a high number of false positives and the scans often miss very small tumors. Yet with all the false positives combined with the mammograms that have missed small tumors, is a mammogram still the safest means of protection for women?

Dr. Mendelsohn says yes, and believes that if a mammogram shows suspicion, then an ultrasound should be performed. “Mammograms are safe as reasonably possible. Could every woman have an ultrasound? Theoretically, yes, but financially the cost would be huge compared to the very little benefit.”

“Mammography is the starting point”, says Dr. Port. “Thorough breast evaluation and early breast cancer detection often requires additional tests minimizing false positives and the need for biopsies that result in benign pathology.”

Other tests such as tomosynthesis (3-D scans), MRIs, molecular breast imaging and thermography are more thorough but also costly and most of them aren’t covered by your typical medical insurance plan.

Do you feel safe relying on mammograms alone? When will you get your first mammogram?

Image: Stockxchng

Understand the risks: Postpartum Breast Cancer


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About Danielle Sullivan


Danielle Sullivan

Danielle Sullivan writes for Babble Pets. She is also an award-winning parenting writer, who authors a monthly column for NY Parenting and ASPCA Parents blog. You can read more of her work at her blog,Some Puppy To Love. Read bio and latest posts → Read Danielle's latest posts →

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0 thoughts on “Reducing The Breast Cancer Risk: Are Mammograms Still Best? And When Should You Start?

  1. kiki says:

    If my mother had followed the PSTF guidelines, she might be dead. They found her cancer at age 63 from a routine yearly mammogram – what if that had been the year off in their every other year recommendation? Had it spread more, they might not have been able to do as much for her and I might not have my vibrant, healthy, wonderful mom around today. I plan to get my first mammogram at age 40…

    As far as needing something else in addition to or as an alternate to mammograms, I wholeheartedly agree – mammograms are painful, and for the reasons above not always the most accurate. As far as the cost goes, the cynical part of me wants to know how much money was spent developing drugs for erectile dysfunction?? Now that old men can successfully get a boner, maybe now some of that time, money and energy can be put towards finding a more economical, less painful method of screening for breast cancer. It could probably also be applied to testicular cancer if anyone needs some motivation…

  2. Roxy says:

    I’m a radiology resident (the doctor who reads the mammogram), and I must say that mammograms have saved a lot of lives at my institution simply by early detection and early treatment.

    As far as other modalities for evaluation. I feel ultrasound is only helpful if the patient feels a lump OR if there is a finding on the mammogram. MRI is very expensive, but it is great for further evaluation of mammograms and for younger women with a positive family history.

    Thermography and molecular: I can’t say much on those, but I think thermography is very operator dependent, and not as many people have training in it.

    Bottom line: do your self breast checks at every age! (A self breast check is what got my friend early intervention. She felt a lump at the age of 29 that turned out to be breast cancer.) Get your mammogram as your doctor advises. Start at 40 unless there is family history or your insurance allows sooner.

    But please please please… do your self breast checks. You can’t rely on your PCP or a nurse practitioner to know your breasts better than you. You have the power to save your own life!

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