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The US Preventive Services Task Force, an influential group of medical experts, recommended last week that most women should have mammograms starting at age 40. Women should have a mammogram every year to screen for breast cancer until age 74. said.
This is a significant difference from the task force’s previous guideline, which called for starting biennial mammograms by age 50. Women under 40 were advised to make individual decisions with their health care provider, but there was no clear recommendation to begin with. They are 50 years old.
I wanted to know more about why these changes were made. Who should follow this updated guideline, and are there women who should have earlier or more frequent screening? What other tests might be needed besides a mammogram? Are there preventive measures that can be taken to reduce the risk of developing breast cancer?
I spoke with CNN wellness expert Dr. Lena Wen to help us with these questions. Wen is an assistant professor of emergency medicine at George Washington University. He previously served as the Baltimore Health Commissioner.
CNN: How common is breast cancer?
Dr. A.S. Lena Wen: In America, there is breast cancer The second most common cancer Among women, it is the second leading cause of cancer death in women. According to the American Cancer Society, 1 in 8 women will develop breast cancer in their lifetime. About 42,000 women They die every year from this cancer.
It is important for women to know their risk factors and get screened accordingly. Screening, by definition, is done before any symptoms are present. Screening helps detect cancers at an early stage, before it has spread, when there is a better chance of successful treatment.
CNN: Why did the US Deterrence Task Force make these changes?
When: In recent years, there has been a disturbing trend in the diagnosis of cancer among young adults. This is the case with colon cancer as well as with breast cancer.
In fact, breast cancer is the most common cancer and the leading cause of cancer death in women 20 to 49. Younger women have more aggressive cancers at diagnosis than older women.
This is especially true for black women. As of 2023, the death rate from breast cancer among black women at age 40 is 27 per 100,000 persons, compared with 15 per 100,000 persons among white women. JAMA Network Open study
According to a study in the journal Lancet OncologyBreast cancer mortality can be reduced by getting mammograms as early as age 40.
The Transformation of the US Preventive Task Force It now brings its recommendations closer to those of other major national organizations. The American College of Obstetricians and GynecologistsFor example, it recommends screening every one or two years starting at age 40 and continuing until at least age 75. American Cancer Society It gives women between the ages of 40 and 44 the option to get a mammogram every year and recommends that those between the ages of 44 and 55 get it annually. (People over 55 can switch every year or continue with annual mammograms.)
CNN: Who should follow this updated guidance?
When: I encourage women to be aware of this updated guideline and discuss it with their doctors. Important These guidelines apply to women at average risk of breast cancer. People at average risk should start getting mammograms by age 40.
This guideline does not apply to high-risk individuals. Everyone should assess their own risk to see if they are at high risk; If so, they may need more tests and a higher frequency than these recommendations.
The updated guidance applies to anyone assigned female at birth, including not only cisgender women but also transgender and non-binary people. These individuals should discuss with their health care providers to assess their risk factors and therefore how often they should receive screenings.
CNN: How should people decide whether they need screenings more often or earlier in their lives?
When: The most important factor is a personal or family history of breast cancer. If someone has breast cancer, they should consult with an oncologist or primary care provider to find out what testing they need and at what intervals they should be monitored for cancer recurrence. The same goes for people who have had radiation to the chest from other cancers.
Family history is also an important determinant of risk. A sister, mother, or other first-degree relative has breast cancer Twice the average risk Breast Cancer. A woman with two first-degree relatives has a fivefold increased risk of developing breast cancer.
CNN: What should women expect from their first mammogram?
When: A mammogram is an X-ray of the breasts. Typically, a technician will take you to a room where you will remove your bra and shirt, wipe off any deodorant from your underarm area that may interfere with the results, and change you into a gown that covers you from the waist down (no need to remove your underwear, pants, or shoes). You will then be taken to a mammogram machine. The technician will position you so the machine can better capture images of your breasts.
You may experience some discomfort during a mammogram as the technician places your breasts between two plastic imaging plates and applies pressure while taking the image. However, the discomfort usually subsides within seconds. Those concerned about possible discomfort can take Tylenol or ibuprofen an hour before the mammogram.
CNN: What other tests might be needed besides mammograms?
When: A person with a family history of breast cancer may be referred for genetic testing. They and others at higher-than-average risk of breast cancer may need to start mammograms at an earlier age or at more frequent intervals. Other tests may be used along with the mammogram. This may include breast ultrasound, breast MRI, or both.
I would like to mention that there are experts who advocate additional screening for women who are at average risk but have dense breast tissue. Mammography is the screening test of choice for these women, but there are instances where they may need additional imaging to better detect possible masses.
The American College of Radiology, for example, recommends a breast MRI for some women who are at intermediate risk but have dense breast tissue. The US Preventive Services Task Force did not make this recommendation, which has implications for insurance coverage for imaging. Someone who is very concerned about their breast cancer risk should discuss the situation with their doctor, who can help them decide what’s best for them based on their personal and family medical history, and the additional costs they may incur.
CNN: What about women over 74? Why should they stop screening for breast cancer?
When: The US Preventive Services Task Force concluded that there is insufficient evidence to recommend or against mammography for women age 75 or older. However, other major medical societies continue to recommend mammography for people 75 or older, especially since they are generally in good health and have a long life expectancy. This, again, is an issue that should be discussed with one’s individual provider, who can consider other aspects of health and the patient’s preferences.
CNN: Are there steps younger people can take to reduce their cancer risk?
When: Risk factors for developing breast cancer include smoking and heavy alcohol consumption, so quitting smoking and reducing alcohol consumption can help reduce the risk. Studies show that exercise generally reduces cancer risk, as does eating whole foods and less ultraprocessed foods.
Women should also seek care if they develop Anything related to symptomsA new lump or lump in the breast or armpit, redness or scaly skin on the breast, nipple discharge other than breast milk, or pain or swelling anywhere in the breast.
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