HEALTHY LIVING New Mammogram Guidelines
Some experts say they’re not strong enough for prevention. ::
BY CHARLOTTE LIBOV B
eginning breast cancer screening at the younger age of 40 will save women’s lives, according to an influential government health panel’s new recommendation — and experts say
that while it’s long overdue, it should still be stronger. “We have agonized over the task force’s guidelines for
years, so we were thrilled when this new recommendation came out,” says Monica Yepes, M.D., division director of breast imaging for the Sylvester Comprehensive Cancer Center at UHealth in Miami. “In 2009, when the task
force announced the age of 50, we had already been recommending screening start at 40,” adds Evelyn May, M.D., a radiologist at Mercy Medical Center in Baltimore.
GUIDELINE SPECIFICS The U.S. Preventive Services Task Force recently issued a draft decision recommending that women in general begin getting mammograms every two years starting at age 40, instead of the current recommendation of age 50. This puts the panel in line with major medical
organizations, including the American Medical Association, the American College of Radiology, and the National Cancer Institute. The task force cited statistics showing that younger
women are increasingly being diagnosed with breast cancer. The panel also voiced concern for younger Black
women, who are slightly more likely to get breast cancer, but 40% more likely to die of the disease than are white women. The task force, which is an independent panel of
national experts in disease prevention and evidence- based medicine, is especially influential because Medicare and private insurers are required to cover the tests they recommend.
BREAST CANCER RISK When it comes to breast cancer risk, age matters.
86 NEWSMAX MAXLIFE | AUGUST 2023
Women ages 40 to 50 have a 1 in 69 risk of developing breast cancer. From ages 50 to 60, that risk increases to 1 in 43. In the 60 to 70 age group, the risk is 1 in 29. In women ages 70 and older, 1 in 26 women are at risk
of developing the disease, statistics say. However, although younger women develop breast
cancer less often, their breast cancer tends to be more aggressive, and is also more difficult to detect because their breasts are denser.
WHY THE SCREENING GUIDELINES SHOULD BE STRICTER
But, much as Yepes and May applaud the task force’s action, they say it falls short because of the recommendation that women get screened every two years, instead of annually. During those two years, an
early breast cancer can become advanced, says May. “This is why, based on the available evidence, we continue to recommend annual screening.” Also, although the task force
recommends imaging start at age 40 for women at average risk, some women “may need to begin screening with imaging as early as 25 to 30 years old,” depending on their family medical history and/or genetics, says Yepes.
This includes Jewish women of Ashkenazi descent, who
may have a higher genetic risk, and Hispanic women and Latinas living in the U.S., as there is some indication their breast cancer may be more aggressive, she adds. Another contentious issue is how long women should
continue to receive mammograms. The task force says there is “not enough evidence”
to assert that women over the age of 74 benefit from mammography, but that is because of a lack of randomized control trials of this population, says Yepes. “I believe women should have mammograms as long
as they are healthy enough to be treated, and if they don’t have underlying conditions that would decrease their life expectancy to less than five to 10 years.” Adds May, “I tell my patients who ask that I would
continue getting my mammogram as long as I can. When the time comes that she is going to die of something else, we can discuss it, but, until then, we welcome women of all ages to keep coming.”
JUICE FLAIR/SHUTTERSTOCK
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