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Posted 11/23/09
Mammogram guidelines:
What changed?

You may have heard that recent mammogram guidelines issued by the U.S. Preventive Services Task Force (USPSTF) call for beginning mammograms at age 50 instead of age 40.
Differing mammogram guidelines
These guidelines differ from those of the American Cancer Society (ACS) and the American College of Radiology. ACS mammogram guidelines call for yearly mammogram screening beginning at age 40 for women at average risk of breast cancer. Meantime, the ACS says the breast self-exam is optional in breast cancer screening.
Mammogram Guidelines:
What changed?

- Differing mammogram guidelines
- What Western Imaging recommends
- Questions and answers
Response to U.S. Preventive Services Task Force (USPSTF) mammogram recommendations:

American College of Radiology   American Cancer Society
View Response #1   View Response
View Response #2    

According to the USPSTF, women who have screening mammograms die of breast cancer less frequently than do women who don't get mammograms. However, the USPSTF says the benefits of screening mammograms don't outweigh the harms for women ages 40 to 49. Potential harms may include false-positive results and accompanying anxiety and stress.

Critics of the new rules say ignoring the health risk is not worth it. Breast cancer is the second leading cause of cancer deaths among women and the seventh leading cause of death overall for women. According to the American Cancer Society, 17% of breast cancer deaths in 2006 were among women who were diagnosed between ages 40 and 49.


What Western Imaging recommends
In accordance with American Cancer Society and American College of Radiology Guidelines, Western Imaging’s current practice is to continue recommending annual screening mammogram beginning at the age of 40.
Breast self-exam to identify breast abnormalities and allow a woman to become familiar with her breasts so that she can tell her doctor about any changes
Clinical breast exam performed by a health care provider and recommended annually beginning at age 40
Annual Screening mammography beginning at age 40
Screening mammograms have detected abnormalities in women in their 40s. These women have then had biopsies and learned they had invasive breast cancer. There are many stories about younger women who have found cancer early as a result of screening. And it's important to remember that most women who get breast cancer have no family history or other risk factors for the disease.

Screening mammography is not a perfect exam. There will be a lot of new data published in the coming months, and it will take time to analyze the results and see what information can be gained to determine how best to use mammography as a screening tool.

In the meantime, women should meet with their health care providers to discuss the benefits, risks and limitations of screening mammograms. If you're concerned about screening mammograms, talk to your doctor and learn what's right for you based on your individual risks. It's important that the two of you work together to develop a screening plan.

Questions and Answers
Q. When should I start getting mammograms and how often should I have one?
A. Mammograms should begin at age 40 and continue annually thereafter, consistent with recommendations by the American Cancer Society and American College of Radiology.
Q. Will the recommendations change insurance coverage?

A. At this moment no and we’ve heard little to the contrary. There’s no way to predict how private insurance plans will respond. Many companies also base their coverage on recommendations from the private groups, such as the American Cancer Society, which still recommends annual mammograms beginning at age 40.

The task force's recommendations have no direct effect on Medicare coverage of mammograms. That's because Medicare is required by law to cover one screening for women ages 35 to 39, and yearly mammograms after that. Medicare's mammogram coverage can be changed in one of two ways: Congress could pass a new law, or the secretary of Health and Human Services could change coverage, after consulting the head of the National Cancer Institute.

Q. Do mammograms prevent cancer?
A. No. They just find it early, when it’s too small to cause a noticeable lump or other symptoms.
Q. Do mammograms reduce women’s risk of dying from breast cancer?
A. Yes. They reduce it by about 15 percent for women in their 40s and 50s, the task force says.
Q. How can women reduce the risk of breast cancer?
A. There’s no way to eliminate the risk of cancer, but research shows women can reduce their risk by limiting their use of alcohol, exercising regularly and maintaining a health weight, according to the American Cancer Society. Breastfeeding for at least several months also reduces the risk, as does avoiding post-menopause hormone therapy.
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