By Meeghan Lautner, M.D.
As a breast surgeon, this is one of the most difficult questions for me to answer. National guidelines have changed recently and there is a lot of criticism, not to mention confusion. This is a result of large organizations like the U.S. Preventive Services Task Force, the American Cancer Society and the American College of Obstetricians and Gynecologists trying to decide the earliest age when a mammogram will save the most lives, but not cause undue stress and anxiety because of multiple biopsies that turn out to not be cancer.
One thing all guidelines do agree on is that screening recommendations should be a “shared, informed decision-making approach.” This means, that every woman should discuss her plan for screening mammograms with her doctor. This includes when to start, how often and when to stop. For some women, it may also include adding other tests such as an ultrasound or MRI.
All guidelines emphasize that screening recommendations vary based upon a woman’s risk of developing breast cancer. Risk factors for breast cancer include family history, menstrual history, pregnancy history, exposure to radiation as a child, obesity, smoking, alcohol use and the list could go on. Considering these risk factors, each woman is different than the next and so are her recommendations for when to start screening mammograms.
All that said, screening mammograms should be considered by every woman and her doctor at age 40. After starting at age 40, the guidelines vary between yearly mammograms and every other year mammograms.
Again, this plan should be individualized for each patient taking into consideration their risk factors and other medical problems. Breast cancer is much easier to treat if found early.