What New Breast Cancer Screening Recommendations Mean for You

The latest debate over breast cancer screenings may leave you with more questions than answers. At what age should you begin mammography screenings? And how regularly do you need them? Are breast self-exams really a useful early intervention? Are clinical breast exams a beneficial supplement to mammography?

New recommendations released in November 2009 from the U.S. Preventive Services Task Force (USPSTF) have called breast cancer screening recommendations into question and have sparked debate and disagreement among breast health experts. So what does it all mean for you?

What Are the New Guidelines?

First, let's break down the new recommendations from the USPSTF. These recommendations are for women at an average risk for breast cancer. Specifically, the new guidelines:

• Recommend against routine screening mammography in women ages 40 to 49. The guidelines suggest that when women reach age 40, they talk with their doctors about the best time to start regular, every-other-year mammography. Other groups -- including the American Cancer Society (ACS) -- disagree, recommending yearly mammography beginning at age 40 for women who are at average risk for breast cancer.
• Recommend that women ages 50 to 74 have screening mammography every other year, rather than yearly
• Say that there's not enough evidence to determine if the benefits of mammography outweigh the risks for women 75 and older
• Recommend against breast self-exams, which women have been urged to do routinely, because evidence does not show that they have helped lower breast cancer death rates
• Say that there's not enough evidence to measure the value of clinical breast exams for women ages 40 and older. A clinical breast exam is a physical inspection of the breast to check for lumps or other changes. It is performed by a health care provider
  

The ACS and the American College of Radiology (ACR) strongly disagree with the new guidelines. The ACR considers the new guidelines a reversal of progress.

But a USPSTF spokeswoman says the new guidelines are part of the task force's standard re-review of all preventive health topics every five years, and are the result of a careful analysis of benefits and risks. For instance, early detection and reduced breast cancer deaths were compared with false-positive results, which can cause anxiety and require more testing.

How Can You Make Sense of the News?

While the debate rages on among experts, here's what you need to know about breast cancer screenings:

• Mammography. Mammography is an important tool for detecting breast cancer early on, when it's easiest to treat. But the benefits and limitations of mammography vary based on factors like age and personal risk. Women should talk with their doctors about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them.
• Breast self-exams. While the USPSTF does not recommend breast self-exams, the ACS says they are an option for women 20 and older as a means of familiarizing themselves with their breasts so they can notice changes more easily. Talking with your doctor about the benefits and limitations can help you decide if you should start performing these self-exams.
• Clinical breast exams. The ACS recommends clinical breast exams at least every three years for all women in their 20s and 30s, and annually for women ages 40 and older. The USPSTF, however, believes there is not enough evidence to assess their value for women ages 40 and older. The new recommendations do not address clinical breast exams for women younger than 40. Women should talk with their doctors about their personal risk factors and make a decision about whether they should have a clinical breast exam.

Always consult your physician for more information.