To Get Mammograms, or Not? Study Recommends Starting at 40

Recent trends in breast cancer detection have wavered. To perform breast self-exams, or not? To get mammograms, or not?

Dr. Jamie Caughran, who helped lead the research team for a recent study on mammography said women age 40 and up should use both methods for detection. High-risk patients should seek advice from their doctors about the age for and frequency of tests.

The Michigan study, completed this year with data from nearly 6,000 women with breast cancer, counters guidelines by the U.S. Preventative Services Task Force, which recommends generally that women get mammograms every two years beginning at age 50. The USPSTF notes that screenings should be determined on an individual basis.

Among other findings in the Michigan study:

• Breast cancer in women younger than 50 was more likely to be detected first by feel than by mammography. Of the women whose tumors were found by feel, 40 percent were younger than 50.
• Overall, 65 percent of the breast cancer cases were detected by mammography, while 30 percent were detected by feel and the other 5 percent by other methods.
• For women diagnosed with breast cancer before age 50, 49 percent of the cases were detected by mammogram. Of those, 18 percent were Stage 2, and 4 percent were Stage 3.
• For women diagnosed with breast cancer before age 50, 46 percent of the cases were detected by feel. Of those, 50 percent were Stage 2, and 17 percent were Stage 3.
• For women over 50, 81 percent of breast cancers are detected through

The worry about breast self-exams is that they may skew results into too many false-positive tests. Some who recommend fewer mammograms have suggested that over-screening leads to unnecessary invasive tests and undue anxiety. However, the 2011 Breast Cancer Symposium of the American Society of Clinical Oncology overwhelmingly supports these preventive measures.

Dr. Chris Flowers, Director of Breast Imaging with the Moffitt Cancer Center & Research Institute, in Tampa, explains how to optimize your chances of finding cancer early.

“Screening mammography every year works best for women younger than 50, who biologically have fast growing tumors that would be missed by screening every two years. It is important to have a mammogram at an American College of Radiology-accredited and -certified facility with digital mammography, as keeping the radiation dose as low as possible is important, along with optimizing the chances of finding an early breast cancer. A center that does a large number of mammograms is also likely to give the best outcomes for treatment.

The downsides are that there may be false positive findings from mammograms, which require biopsy or even treatment. But these can be minimized by going to a high-quality breast service.

State statistics from the National Cancer Institute show that Florida is doing relatively well when compared with the rest of the United States. There has been a significant fall in the number of women dying from breast cancer in both white and Hispanic groups. In the black community, there has been a reduction in the number of deaths, but not to the same extent as in the other racial groups.

It is even more important than ever to get your annual mammogram, despite the economic situation, but even more has to be done to care for our black population who are falling behind Hispanics and Whites.”