Here's to You: Early breast cancer screenings still best for most women
More women may be putting off much needed breast exams than in past years. Although mammograms can spot breast tumors, many women are confused of when to begin breast exams, stemming from unclear guidelines.
Recent research shows the number of women in their 40s having mammograms has dropped since 2009, when the U.S. Preventive Services Task Force (USPSTF) recommended that women receive mammograms every two years after they turn 50, and younger women should consult with their doctor to decide, a contradiction from the years of guidelines recommending women begin screenings every year after they turn 40.
The USPSTF says the updated guidelines were meant to spare women some of the risk, anxiety and expense of extra tests needed to distinguish between cancer and harmless lumps, but the American Cancer Society, Thibodaux Regional Medical Center and many other organizations endorse yearly breast exams for women starting at age 40, stressing that mammograms have been proven to save lives by detecting tumors early, when they are most treatable.
"Mammography saves a significant number of lives in all women 40 and over," said Camile Richard, Director of Imaging at Thibodaux Regional. "There is no reason not to recommend that women of average risk begin annual screening mammography at age 40."
Recent studies show that the benefit of mammography greatly exceeds any risks that may be involved. Evidence strongly supports the mortality benefit of annual screening mammography beginning at age 40, whereas potential harms of screening are minor.
A study from the University of Colorado and University of Michigan in the February issue of the American Journal of Roentgenology using the same risk models as the USPSTF found that annual mammograms starting at age 40 save 65,000 more women from breast cancer and cuts the risk of dying by 71 percent compared to a 23 percent reduction in risk if women began screenings at age 50.
In a separate study, conducted at the University of Missouri in Columbia, MO comparing women treated for breast cancer that had a mammography screening and those identified under other clinical methods, researchers found excluding women ages 40 and 49 years of age from annual exams under the USPSTF mammography guidelines would negatively impact survival.
Screening women age 40 to 49 with mammography detected smaller breast cancers, with less chance of spread to the lymph nodes, than relying on clinical breast exams alone. Five year disease-free survival rate was estimated at 94 percent for mammography group and 78 percent for those identified clinically.
"Breast cancer found in its earliest stages offers the greatest chance of remission and survival, and a mammogram can detect cancer as much as a year or two before you or your doctor can feel it," said Jay Fakier, MD, Radiologist at Thibodaux Regional. "But breast self-exam is still an important part of a woman's wellness."
Breast cancer is the most common cancer in women worldwide. It kills 500,000 people globally every year and is diagnosed in close to 1.3 million people around the world.
Jonathan Carothers is project manager for Thibodaux Regional Medical Center in Thibodaux, La.