5 Things to Know About the Recent Updates to Mammogram GuidelinesMay 17, 2023 - Katie McCallum
Perhaps you've heard that breast cancer screening guidelines are changing.
The updates come as the result of new, draft recommendations from the U.S. Preventive Services Task Force (USPSTF), an independent panel of national experts in evidence-based medicine that works to set guidelines on preventive healthcare strategies, including screenings.
Notably, the panel is recommending lowering the age at which screening mammograms should begin.
"Mammography is our most powerful tool in the fight against breast cancer in women," says Dr. Luz Venta, medical director of Houston Methodist Breast Care Centers. "Detecting breast cancer early is critical. The earlier we find it, the easier it is to treat and the better the person's prognosis."
According to the American Cancer society, breast cancer-related deaths dropped 38% between 1989 and 2014, thanks to breast cancer screening and improved treatments.
But there's still more work to be done. It's why the USPSTF is making big changes to the formal screening mammogram guidelines.
"One of the factors that influenced the decision to make changes is the increasing evidence showing that some Black, minority and Jewish women develop and die from breast cancer by the time they are 50 more frequently than white women," adds Dr. Venta. "Finding these cancers early is crucially important in this group."
What are the changes exactly? And what do they mean for you? Dr. Venta shares the five things she wants women to know.
1. Women with average breast cancer risk (those with no known risk factors) should begin mammograms starting at age 40
In the draft guidelines released May 9, 2023, the USPSTF is now recommending that all women with average risk of breast cancer begin getting screening mammograms at age 40.
Previously, the task force recommended that mammograms begin at age 50 for women. Those recommendations said women aged 49 and younger should talk to their doctor about when to start and how often to get a mammogram.
"At Houston Methodist, we've been advising women with no known risk factors for breast cancer to begin getting an annual mammogram at age 40 for quite some time, so this isn't a surprise or even a change for us," says Dr. Venta. "These guidelines are simply catching up to what we're already doing. This isn't the case everywhere, though. This will be a change for many women who receive care elsewhere."
If you're between 40 and 49 and haven't yet initiated your annual mammogram, make a plan to schedule an appointment today.
These guidelines won't be a change for everyone. If you're 40+ and already getting a mammogram every year, Dr. Venta says to continue with your current care plan.
2. Our experts recommend annual mammograms
The USPSTF's draft recommendations don't go as far as to recommend women get a mammogram every year starting at age 40, but experts at Houston Methodist do.
"Annual mammograms starting at age 40 save lives," says Dr. Venta. "That's why — even though the task force recommends every other year — we will continue to advise our patients and community to make time for a mammogram every single year starting at age 40."
3. Talk to your doctor about breast cancer screening if you're over the age of 75
The USPSTF draft guidelines recommend that women over the age of 75 and at average breast cancer risk no longer need an annual mammogram, but Houston Methodist doctors stop short of such a sweeping cutoff. Dr. Venta stresses the importance of making this decision with your doctor and within the context of your unique medical history.
"Women should continue to get annual mammograms beyond the age of 74, unless severe medical problems lowers their life expectancy," said Dr. Venta.
4. These changes apply only to women with average breast cancer risk (without known risk factors)
If your breast cancer risk is high, you will need to start having an annual mammogram, and in some cases MRI, before the age of 40. Talk to your doctor about when screening should start for you.
Reasons a woman may be higher risk for breast cancer include:
- Genetic testing has revealed that you carry a gene mutation that increases your risk of breast cancer
- Having a parent, sibling or child with a known breast cancer gene mutation
- Undergoing radiation therapy to the chest
- Having Li-Fraumeni syndrome, Cowden syndrome or Bannayan-Riley-Ruvalcaba syndrome, all rare genetic disorders that increase the risk of certain cancers
5. If eligible, don't delay your annual mammogram
According to the USPSTF, the draft changes to mammogram guidelines could result in 19% more lives being saved.
"Breast cancer risk increases with age," says Dr. Venta. "And the truth is that this increased risk doesn't magically start at age 50. And as a matter of fact, it doesn't start at age 40 either. It happens slowly over time."
For instance, the risk is a little higher at age 51 than 50 and at age 41 than 40, she notes. The goal with screening, then, is about balancing breast cancer risk with the benefit of mammography, catching the most tumors as possible, as early as possible.
"The science absolutely shows that women between the ages of 40 to 49 benefit from the lifesaving value of mammography," says Dr. Venta. "We're very pleased the formal guidelines are changing to help reinforce the importance of mammography in this age group of women."