Screening mammograms are a vital tool in detecting breast cancer early. Early detection significantly improves the chances of successful treatment and can mean less invasive treatments are required. The United States Preventive Services Task Force (USPSTF) regularly reviews and updates guidelines to ensure the best possible care for patients. May 9, 2023, the USPSTF released a Draft Recommendation Statement for updated mammogram guidelines that provide valuable insights into screening practices. It is important to understand these guidelines in order to make informed decisions about your breast health.
What change is the USPSTF recommending regarding mammogram screening?
The new guidelines recommend that all women get screened for breast cancer every other year starting at age 40 to reduce their risk of dying from this disease. (Previously, the recommendation was for regular screening to start at age 50. Women in their 40s were encouraged to make an individual decision about when to start screening, taking into account their health history, preferences, and how they value the different potential benefits and harms.)
What are the potential harms associated with screening mammograms?
Potential harms of screening mammography include false-positive results, which may lead to psychological harms, additional testing, and invasive follow-up procedures; overdiagnosis and overtreatment of lesions that would not have led to health problems in the absence of detection by screening; and radiation exposure.
Are there specific recommendations for women with dense breasts?
Nearly half of all women have dense breasts, which increases their risk for breast cancer and means that mammograms do not work as well for them. Women are generally told by their clinician that they have dense breasts after they’ve had a mammogram. These women deserve to know whether and how additional screening might help them stay healthy. Unfortunately, there is not yet enough evidence for the USPSTF to recommend for or against additional screening with breast ultrasound or MRI.
The USPSTF is calling for studies to determine how additional screening with breast ultrasound or MRI might help women with dense breasts.
Are there specific recommendations for breast cancer screening for Black women?
Black women are 40 percent more likely to die from breast cancer than White women and too often get aggressive cancers at young ages. Ensuring Black women start screening at 40 is an important first step, yet it is not enough to improve these inequities. It’s important that healthcare professionals involve patients in a conversation on how best to support them to ensure equitable follow-up after screening and timely and effective treatment of breast cancer.
The USPSTF is urgently calling for more evidence to better understand whether Black women could potentially be helped by different screening strategies.
The USPSTF is also urgently calling for more research that will allow them to build on the existing recommendations and help all women live longer and healthier lives. Specifically, we need to know how best to address the health disparities across screening and treatment experienced by Black, Hispanic, Latina, Asian, Pacific Islander, Native American, and Alaska Native women.
When should mammogram screening for breast cancer end?
The Task Force found that there is not enough evidence to make a recommendation for or against screening in women ages 75 and older. These women should decide together with their clinicians what is best for their individual health needs, based on their preferences, values, and health history.
The Task Force is calling for more studies on the benefits and harms of screening in older women so they can make a more definitive recommendation for these women in the future.
Why is this change in the USPSTF recommendations important?
Among all U.S. women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2022, an estimated 43,250 women died of breast cancer. Incidence has gradually but significantly increased among women ages 40 to 49 years from 2000 to 2019, with a higher rate of increase 2015-2019.
The change in recommendation to earlier screening could result in 19 percent more lives being saved.
If you would like to read the full recommendation statement, you can find it here:
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Dr. Anita Bennett MD – Health Tip Content Editor