Breast Cancer Screenings to Begin at Age 40 and 50, Experts Say
Breast cancer is a major health concern for women around the world. It is the 2nd leading cause of death amongst women behind heart disease in the US, and the most common cancer diagnosed globally. With such a high prevalence, it is critical that screening recommendations are up-to-date and effective.
This week, the US Preventive Services Task Force issued an updated recommendation urging women to start getting mammograms 10 years earlier than the previous recommendation. Instead of starting at 50 years old, the new recommendation calls for women to start receiving mammograms at age 40. This recommendation is considered a gold standard, as the US Preventive Services Task Force makes their recommendations based on an in-depth review by independent experts.
This recommendation should bring more alignment across the board, where recommendations on the age to receive mammograms have previously been divided (more on this below!).
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What is a mammogram?
A mammogram is a type of medical imaging test that uses low-dose X-rays to create images of breast tissue. Mammograms are used as a screening tool to detect breast cancer in women who have no signs or symptoms of the disease. They can also be used to diagnose breast cancer in women who have symptoms, such as a lump or discharge from the nipple.
During a mammogram, the breast is compressed between two plates to spread out the tissue and make it easier to see on the X-ray image. Two X-ray images are taken of each breast - one from the top and one from the side. The entire procedure usually takes about 30 minutes and can be uncomfortable for some women, but it is generally not painful.
What research is backing the new recommendation that women should start receiving mammograms at age 40?
As we mentioned at the beginning of this article, breast cancer is the 2nd leading cause of death amongst women behind heart disease in the US, and the most common cancer diagnosed globally.
Recent evidence has shown an alarming increase in the number of women being diagnosed with breast cancer in their 40s. Researchers estimate that beginning mammograms at the age of 40 could potentially reduce the US mortality rate of breast cancer by around 20%, which could potentially save 8,000 lives every year.
This recommendation could also help address the disparity in breast cancer mortality rates among black women, who have been found to have more than a 40% increased risk. The task force is also calling for more research to better understand screening recommendations for women of color and those with dense breast tissue. Although dense breasts aren’t considered an abnormal health condition, women with dense breast tissue are more likely to be diagnosed with breast cancer, so understanding the best screening recommendations for this group is critical.
What are the current recommendations for mammograms?
Mammogram recommendations & access to care in the US:
The American Cancer Society and the American College of Obstetricians and Gynecologists already recommend mammograms for women starting at 40. The ACS recommends women at an "average" risk of breast cancer should be offered the option of being screened every year once reaching 40 years old, whilst the ACOG recommends women receive a mammogram once every 1 to 2 years starting at age 40.
The Affordable Care Act in the US also means the majority of private health insurers are required to provide coverage for yearly mammograms without cost sharing, which means they’re free for patients.
Mammogram recommendations & access to care in the UK:
In the UK, the NHS currently offers breast cancer screenings to women once they reach 50 years old every 3 years until 71 years old, you will automatically receive an invite if you are registered with a GP. If you're a trans man, or trans woman, or are non-binary you may be invited for a breast screening automatically, or you may need to talk to your GP surgery or call the local breast screening service to ask for an appointment. After age 71, you can still get screened every 3 years but you will not automatically be invited.
Mammograms for people under 50
Mammograms are typically not included in routine screening for individuals under the age of 50 as their risk of developing breast cancer is generally lower; to give some perspective around 9% of all new cases of breast cancer in the US are found in women younger than 45 years of age. Mammograms may also be less effective for younger women due to the density of their breast tissue, which can make it more challenging to interpret the images.
However, if there is a history of breast cancer among close family members, an individual may be at increased risk if they have inherited specific gene mutations. In such cases, a genetic test may be offered by a clinic to confirm whether an individual is at higher risk due to their family history of breast cancer.
The takeaway
The updated recommendation by the US Preventive Services Task Force urging women to start receiving mammograms at age 40 instead of 50 is a critical step forward in breast cancer screening. With breast cancer being the second leading cause of death among women in the US and the most common cancer diagnosed globally, it is crucial to have effective and up-to-date screening recommendations. Furthermore, the recommendation could help address the disparity in breast cancer mortality rates among black women.
Access to mammograms and screening recommendations vary by country, but it is important for individuals with a family history of breast cancer to discuss their risk with their healthcare professional and for all women to get regular screenings when recommended.
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