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What You Should Know About the ACS’ Recommendations for Mammograms

Thank you to Cheryl Goldsby, of Radiology Imaging Associates.

What You Should Know About the ACS’ Recommendations for Mammograms

On October 20th, the American Cancer Society (ACS) revised their breast cancer screening guidelines.  They are now recommending that women at average risk of breast cancer get annual mammograms starting at age 45 rather than 40, and that women 55 and older scale back screening to every other year.  As the Marketing Director for Radiology Imaging Associates, I have been inundated with questions from women about these new recommendations.  

I am passionate about helping women make informed healthcare choices for both themselves and their families.  It’s important to remember that these are only guidelines — I would strongly recommend that you speak with your medical doctor about your individual risk factors and how these new recommendations impact your personal healthcare. 

In conversations over the past few weeks, I’ve heard lots of confusion. I wanted to take the time to address some of the common misconceptions floating around, attempting to justify why the ACS revised their guidelines.  Hopefully these facts will help you to better facilitate a conversation with your doctor.   

Misconception #1: “The ACS made this recommendation because they believe early detection in the affected age groups doesn’t make a difference in mortality rates.”

FACT:  The ACS has not changed their position that annual mammography screening starting at age 40 saves the most lives.  In fact, the ACS reports there has been a 33% drop in breast cancer mortality in the U.S. since 1990 as a result of early screening and improved treatments.  Here are the 5 year breast cancer survival rates:

  • Stage 0 – 100%
  • Stage 1 – 100%
  • Stage 2 – 93%
  • Stage 3 – 72%
  • Stage 4 – 22%

Here is what the ACS says about early detection and mammograms:

“Regular mammograms can often help find breast cancer at an early stage, when treatment is most likely to be successful.  A mammogram can find breast changes that could be cancer years before physical symptoms develop. Results from many decades of research clearly show that women who have regular mammograms are more likely to have breast cancer found early, less likely to need aggressive treatment (like surgery to remove the entire breast [mastectomy] and chemotherapy), and more likely to be cured.” 

Misconception #2: “Risk of Breast Cancer Decreases with Age.”

FACT:  Your risk actually increases with age.  Here are the statistics from the ACS on an American woman’s chance of developing breast cancer at a specific age:

  • Age 30 – 1 in 227
  • Age 40 – 1 in 68
  • Age 50 – 1 in 42
  • Age 60 – 1 in 28
  • Age 70 – 1 in 26

Misconception #3: “I don’t have a family history, so I don’t need to worry about breast cancer.” 

FACT:  According the ACS, 75% of the women diagnosed each year have no known risk factors.  They have no known family history and no genetic predisposition (BRCA 1 or 2 mutation).

At this point, you are probably asking yourself why the ACS changed their recommendations for screening mammograms…

Well, for those women age 55+, the new ACS recommendation is for biennial screenings.  When my 72-year-old mother called and asked me if she should skip her mammogram, here’s what I told her:

Statistically, women in her age group develop more cancers (1 in 26), but on average, they tend to be slower growing.  We currently have no way to predict if her cancer will but the turtle or the hare variety – and finding cancer a year later will likely mean more aggressive treatments.  Perhaps the difference between a mastectomy or a lumpectomy.  Perhaps the difference between chemotherapy or no chemotherapy.

The ACS has also recommended raising the age for women to begin screening mammograms from age 40 to age 45 due to concern for the stress of false-positives on patients.  A false-positive is when the radiologist sees an area of suspicion on a patient’s mammogram and calls the patient back for additional imaging. Most of these are cleared up by a simple ultrasound while a few will go on to have a biopsy.

I can tell you first hand being called back for further imaging is stressful!  However, for me, the choice is clear.  I would prefer to take my chances of having short-term anxiety resulting from a false-positive than take my chances of missing a cancer diagnosis and treatment. 

The ACS statement strongly advises that the choice should be left up to the patient.  But, remember, they are only guidelines.  Your choice may be different than mine.  But, I do hope that it is based on a factual conversation with your medical doctor. 

–Posted by Cheryl Goldsby, Radiology Imaging Associates

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