To Your Health
Are you still unsure about how often you need
a mammogram?
Director
Providence Milwaukie Hospital
Family Medicine Residency
The U.S. Preventive Services Task Force is an independent expert panel that periodically reviews the best available evidence and then updates screening and prevention guidelines. It has recently updated the mammography screening recommendations. The National Cancer Institute has reviewed the recommendations and concurs that they are based on the best available evidence. However, the recommendations have created some confusion as they relate to individual patients.
Breast cancer is the most common non-skin malignancy among women in the United States, and second only to lung cancer as a cause of cancer-related death in women. For all women, the risk for developing breast cancer increases with age. The probability of developing invasive breast cancer in your 30s is less than 1 percent; by the time you’re nearing age 70, that risk is almost 4 percent.
A mammogram cannot prevent breast cancer but can find it early, when lumps are too small to be felt through self-examination. There’s no way to completely eliminate the risk of cancer, but research shows that women can reduce their risk by limiting their use of alcohol, exercising regularly and maintaining a healthy weight. Breastfeeding for at least several months also reduces the risk, as does avoiding postmenopause hormone therapy.
The U.S. Preventive Services Task Force review confirms that a mammogram is one of the most important health screenings a woman can have. Women between the ages of 50 and 75 are strongly encouraged to get regular mammography, at least every other year. Data from both Providence Health Plan and Providence Medical Group indicate there are large numbers of women who are not taking advantage of this potentially lifesaving opportunity.
For women less than 40 years old, there is no evidence that routine mammography is helpful, though there may be a role for structured clinical breast examination. For women 40 to 50 years old, the risk of overdiagnosis and inappropriate intervention is approximately equivalent to the benefit of detection and treatment of breast cancer. If you are between 40 and 50, you should discuss screening strategy with your primary care physician.
For women after age 75, the evidence is unclear at this time and further research is needed. Women over 75 clearly get breast cancer, but the risk of detection of small cancers that may not be clinically significant goes up dramatically, and mammography probably results in significant overtreatment.
For women of any age: If you or your bed partner discovers a lump, unusual thickening or persistent localized tenderness, you should have this evaluated by your primary care physician. These are not symptoms that should be ignored in the hopes that they will go away!
Because each woman is different, the risk of developing breast cancer depends on many factors, including family history and your own personal health history. The U.S. Preventive Services Task Force emphasized that its recommendations do not apply to high-risk patients or patients with breast symptoms.
If you have questions about when you should schedule your next mammogram, please contact your Providence medical clinic. Breast cancer detection is just one of many reasons you should see your physician periodically. When it comes to frequency of health screenings, whether for breast cancer or other conditions, you and your doctor can determine the best schedule for you based on your age, lifestyle and individual risk profile.
www.providence.org/pmg
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