October is Breast Cancer Awareness Month. Nearly 270,000 women in the United States are diagnosed a year, and about 70% of women age 50 and older are screened at least every other year.
Although most people are aware of breast cancer, there may be some confusion about how often to be screened.
Earlier this year, news headlines told of a new set of guidelines from one of the most well-known professional organizations. And about a set of different guidelines from another, equally respected group.
The American Cancer Society recommends women from the age of 45 through 54, who have an average risk of breast cancer, get a mammogram every year; every other year at 55 and older.
The American College of Physicians recommends that most women get a mammogram every other year beginning at age 50; younger women should speak to their doctor about whether they should get one.
With different sets of guidelines, how do you know what to do?
Screening guidelines are based on many factors, including the fact that there may be harm caused by further testing and treatment.
“Screening guidelines have to balance the benefits with the risks,” says Safina Koreishi, MD, Columbia Pacific CCO medical director. “Some guidelines make finding as many cancers as possible the priority; other guidelines make harms, risk or individual patient outcomes the top priority.”
The United States Preventive Services Task Force (USPSTF), a group that reviews these benefits and harms, looks for a balance and recommends screenings that are shown to benefit most patients. The USPSTF, as well as the American College of Physicians, agree that most women at normal risk should get a mammogram every other year beginning at age 50.
It’s also important to remember that both sets of guidelines are for women who are at average risk of breast cancer. Women who are at higher risk should begin screening at a younger age, be screened more often, or both.
Factors that can increase risk include:
- Personal health history, including prior abnormal screenings, a previous diagnosis of breast cancer, or a genetic variation known to increase risk. the BRCA1/2 gene mutation)
- Family history of breast cancer at a young age or in several family members.
“The best guideline is to talk with your health care provider about your own personal situation and your concerns and wishes,” says Dr. Koreishi. “Working together with your provider, you can decide what type of screening you should have, and how often you have it.”