Confused About New Mammogram Recommendations?

Well, here we go again ladies! (and the men who help empty their drains after breast cancer surgery.) The latest word is you don’t need a mammogram until age 45 if you are at average risk for cancer. Here’s why so many breast cancer survivors are confused about the American Cancer Society’s new mammogram recommendations:

Three important medical organizations now have three very different guidelines for when to start getting mammograms.  The American College of Obstetricians and Gynecologists recommends age 40. The U.S Preventive Services Task Force says 50.  Now, the American Cancer Society is splitting it right down the middle, recommending women who are at average risk start mammograms at age 45.  Who’s right?  Who the heck knows?!

Confused about New Mammogram Recommendations?

Why the change?  You can read this article in the Journal of the American Medical Association.  It’s long, technical and gave me a headache, so why not read my Cliff Notes version instead?  Here are the American Cancer Society’s basic arguments in favor of mammograms at age 45: 

New Mammogram Recommendations Will Cut Down on False Positives

The ACS points to false positive mammography results and the stress and anxiety they cause women.  WHAT?  We’re big girls, we can take stress and anxiety. I had a false negative! (Which of course, caused No Stress.)  I found cancer myself, in the shower. (Slightly stressful, but again, I can take it.)


Stress… what medications do I take and does it even matter now that I have cancer?

My cancer wasn’t detected by a mammogram, but I’m still glad I had one. Mammograms have detected cancer in countless women in their early forties.  Is this really about stress and anxiety?  Or is it about false positives costing our health care system four billion dollars per year?  

New mammogram recommendations will not affect mortality

According to the new mammogram recommendations, the mortality rates from breast cancer are virtually the same among breast cancer patients who are diagnosed through mammograms versus those diagnosed through other means.  Wow.  Wouldn’t you still rather be diagnosed earlier than later?  Wouldn’t you like even a chance to avoid chemo, radiation, the cancer spreading to your lymph nodes, bones, liver, spine or brain?  Not a guarantee, but a chance?


The treatments are more stressful than a false positive!

The reasoning seems to be, “A bunch of you are going to die no matter what, so why bother with mammograms at age 40?”  Here’s why: quality of life.  Oh, and that stress and anxiety thing mentioned above?  It’s much higher during cancer treatment than during a false positive.

New mammogram recommendations look at cancer risk by age

The JAMA article says while cancer risk is steadily rising starting from age 40, it’s not as high as the risk at age 45 and 50.  A 40 year old’s risk of getting breast cancer is .06 percent.  A 45 year old’s is .09 percent.  A 50 year old’s risk is 1.1 percent.  I’m not a statistician or a scientist, but is that such a huge disparity in risk?  Who is drawing the line here?  A bean counter who is weighing what mammograms cost and whether insurance companies should be required to cover them? 

I do thank the American Cancer Society for acknowledging in these latest recommendations that women should be able to choose to start mammograms at 40 if they want to.  I hope women continue to get them. Mammograms aren’t fun, they’re not always accurate but mammograms and self exams are all we’ve got as far as screening goes!  (The new recommendations also advise against your doctor feeling your breasts for problems, so selfies are more important than ever!)

Ironically, back in 2009 the American Cancer Society was highly critical of the U.S. Preventive Services Task Force for recommending mammograms start at age 50.  Now, ACS, a charity I still support, is adding more mud to the muddy waters of breast cancer detection and treatment.  

As these new recommendations become public, social media is being inundated with breast cancer survivors commenting about being diagnosed well before age 45, about lives being saved by mammograms, and about confusion deciphering all of the medical jargon, science, and politics behind cancer.  There are lots of anecdotes.  They may not be medical statistics, but all those anecdotes add up to something, don’t they?

Well, this kinda sucks. But it could be much, much worse.