A Tour of Mammographic Screenings During Your Life
A life-saving test
Friday marks a little-known day of commemoration in health history: It's National Mammography Day. In 1993, former President Bill Clinton declared that the third Friday of National Breast Cancer Awareness Month should be dedicated to encouraging women to get mammograms. Many experts say "screening mammograms save lives." There has been some controversy over when to start screenings -- whether in the fourth or fifth decade of life. Here are general recommendations on factors influencing the decision to screen or not in each decade.
20s
The majority of women in their 20s don't have to worry about breast cancer or mammographic screenings. But consider a mammogram if you're at high risk of breast cancer -- which means having a first-degree relative (mother or sister) diagnosed with breast cancer before age 50 or a relative with ovarian cancer. Also, if you've tested positive for the BRCA genes, get a baseline mammogram in your 20s, or preferably an MRI, says Jame Abraham, director of the Breast Oncology Program at the Taussig Cancer Institute of the Cleveland Clinic.
30s
Only women in their 30s who are at high risk of breast cancer should get screened, Abraham continues. If you are not at high risk, but only medium-high risk (you have a first-degree relative with breast cancer diagnosed after age 50), you should wait because the risk of false positives and second screenings is greater the younger a women is. That's because younger women have denser breast tissue, which is an independent risk factor for breast cancer, but it can also have a masking effect, which can lead to second screenings.
40s
The real benefit to beginning mammograms at age 40, as the American Cancer Society suggests, is early detection, Abraham says. Studies have shown that 40-something women whose cancer was detected by mammograms had earlier-stage cancer and less need for radical surgery or treatments. However, the official guidelines remain split on whether the 40s are too early, since breast cancer strikes women most frequently in their 50s and 60s. The U.S. Preventive Services Task Force recommends beginning at age 50.
50s and 60s
Cancer is a disease of aging, and the 60s are when most breast cancers appear, Abraham says. These are the ideal decades to rely upon mammograms: Your breasts are becoming less dense, so mammograms will be easier to read and more accurate at detecting worrisome lumps, as opposed to the fluid-filled cysts that also start to develop.
70s
Continuation of mammographic screening will largely depend on your predicted longevity. The USPSTF says you can stop at age 74, but Abraham says, "If your longevity is high, don't stop getting mammograms." In other words, if your overall health is good, keep it that way with regular screenings. If you have a lot of other conditions that compromise your health and potential longevity, then you can stop.
Kristine Crane is a Patient Advice reporter at U.S. News. You can follow her on Twitter, connect with her on LinkedIn or email her at kcrane@usnews.com.
