In 2009 the U.S. Preventive Services Task Force came out with mammogram recommendations that upset many patients and physicians. Chief among these was that routine mammograms in low risk women were not to start until age 50 and then only every 2 years.
Despite these findings, other organizations, such as the American Cancer Society and the American Congress of Obstetricians and Gynecologists, continue to recommend yearly mammograms starting at age 40.
I have always recommended to my patients that they should start their breast cancer screenings at 40 and try to get them yearly. I know that sometimes those twelve months stretch into 15-18 months, and that is one of the reasons I think women should aspire to an annual schedule. Many women who attempt to schedule a mammogram every two years, often end up waiting 2.5 to 3 years between tests and that time can make a huge difference in a woman’s breast health. For high-risk women who either have a mother or a sister who has had breast cancer, I recommend that annual mammograms start at age 35.
All women should remember that most women who get breast cancer do not have a family history of it. Prior to age 35, screening mammograms just don’t work that well to see microcalcifications, which can be the radiologic signs of an early cancer. For the clearest image and the best reading, a woman should make sure that she is getting a digital mammogram, which, fortunately, are offered at most facilities in the Hampton Roads area.
For women with a strong family history of breast cancer though there may be a role for MRI screening in screening. MRI screening, a newer technology, might pick up more cancers earlier, but it is far more costly and less available than regular mammograms and it isn’t suitable for annual screening for most women at this time.
One bit of good news about cancer prevention and screening is that insurance companies are being directed by the government to remove financial obstacles to effective screening tests such as mammograms. This means that for most plans, there is no co-pay or deductible when getting a mammogram. So, other than the brief squeezing, there’s no reason not to get one when it is time!
Dr. Craig H. Ruetzel has practiced in Hampton Roads since 1992. In addition to his comprehensive knowledge of women’s health topics, Dr. Ruetzel performs several highly-specialized and minimally-invasive procedures including laparoscopic hysterectomy and urinary incontinence surgery. Dr. Ruetzel is board certified by the American Board of Obstetrics and Gynecology and is a member of both the Medical Society of Virginia and the American Congress of Obstetricians and Gynecologists.