On April 30, the United States Preventive Services Task Force (USPSTF) released new guidelines that lower the age of recommended screening mammography from 50 to 40 years of age. Ironically, it was the USPSTF who first raised the recommended age from 40 to 50 in 2009.
According to USPSTF chair Dr. Wanda Nicholson, “More women in their 40s have been getting breast cancer, with rates increasing about 2 percent each year…by starting to screen all women at age 40, we can save nearly 20 percent more lives from breast cancer overall.”
Unfortunately, the updated recommendations do not include screening for women over 74 years of age, nor do they recommend annual screenings. Many leading medical groups have issued statements saying that the new recommendations do not go far enough.
The American Cancer Society recommends annual screenings, as does the American College of Radiology, the Society of Breast Imaging and the American College of Obstetricians and Gynecologists. Dr. Richard Rupp, a radiologist with RadX Imaging Partners, said “Studies show that up to 20% of cancers occur in women under the age of 50, and many of these are more invasive, aggressive forms of cancer. It is now a known fact that annual screenings save significantly more lives than biennial screenings.”
Dr. Rupp says that 40 is a good starting age for most women, however women at an increased risk for breast cancer, as well as black and Jewish women, should talk with their doctors about their breast cancer risk before their 25th birthday. “In some cases, these women at higher risk may want to start annual mammograms before they turn 40,” he adds. “And because women are living longer, screening should continue beyond age 74 for women in good health.”
Breast cancer risk assessment includes age, family history, prior screenings and other clinical factors. Women who aren’t sure about their individual risk are encouraged to talk with their doctors, who can provide a more in-depth breast cancer risk assessment, using a tool such as the Tyrer-Cuzick Risk Assessment Calculator. If a woman’s cumulative lifetime breast cancer risk is greater than or equal to 20%, she is considered high risk and may benefit from supplemental forms of screening.
