Sunday, November 1, 2015

New American Cancer Society Guidelines for Mammograms

The American Cancer Society, which traditionally has taken an aggressive position towards screening for breast cancer, has softened its stance on the need for mammograms to detect breast cancer. The new guidelines are published in the Oct. 20 issue of JAMA, along with an editorial summarizing the new recommendations.

Previously, the cancer society had been recommending yearly mammograms after the age of 40. The new guidelines recommend that women have annual mammograms starting at the age of 45, and then only every other year after the age of 54 provided that they are healthy and not at high risk of breast cancer. That brings the cancer society's recommendations more in line with the United States Preventive Services Task Force (USPSTF), which recommends biennial mammograms only after the age of 50. In addition, the ACA no longer recommends clinical manual breast exams (in which the health care provider feels for lumps) at any age.

The new guidelines reflect the latest scientific evidence that annual mammograms are not very useful in younger women and that they can result in false positive results, leading to unnecessary additional tests, including biopsies. However, don't expect physicians or patients (who've been conditioned for decades to fear cancer and to take any possible action against it) to immediately accept the new guidelines. There will still be those who take a "better safe than sorry" approach and continue with their yearly mammograms.

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