For the previous 50 years, women have been urged to have common mammograms—breast X-rays that assist healthcare suppliers discover suspicious lumps.
So you in all probability assume that by now, specialists would all agree on when women ought to have this breast most cancers screening check.
But they do not.
Three main health organizations—the American Cancer Society, the U.S. Preventive Services Task Force, and the American College of Obstetricians and Gynecologists—disagree on when to begin screening, how typically women ought to bear mammography, and at what age to cease, if ever.
They even have totally different takes on the advantages of medical breast exams—having a physician manually look at breast tissue for lumps or different attainable indicators of most cancers.
In the face of such inconsistent recommendation, what do you have to do?
First, don’t use the conflicting recommendation as a cause to skip breast-cancer screening. “Yes, the groups differ on some particulars, but they agree on this: Regular screening saves lives,” says Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser.
For National Women’s Health Week, we take a look at the positions of the three teams and the elements to contemplate when selecting your breast most cancers screening technique.
“Women need to understand the evidence, and they should consider their own cancer worries so that they make informed choices that are right for them,” Lipman says.
Weighing Testing’s Benefits and Harms
The advantages of mammograms are apparent, Lipman says: fewer deaths from breast most cancers. The American Cancer Society, for instance, in its new suggestions, factors to analysis involving tons of of hundreds of women displaying that common screening has reduce breast most cancers deaths by 35 to 50 %.
The dangers of breast most cancers screening, although much less acquainted to shoppers and even to some docs, are of accelerating concern to many specialists. The two essential dangers:
- False alarms. Mammograms typically trigger false positives, outcomes that originally appear worrisome however show to be innocent on follow-up checks. For instance, a current evaluation by the duty drive discovered that 42 % of women who get screened each two years for 10 years beginning at age 50 may have a minimum of one false constructive mammography.
Getting screened yearly makes it extra probably that you’re going to expertise a false alarm, as does beginning in your 40s, Lipman notes. False alarms may cause useless nervousness and lead to extra mammograms, which expose you to radiation—and typically to pointless biopsies.
- Overtreatment. Some cancers detected by mammography after which handled are unaggressive tumors that might have by no means have prompted hurt. Treating these cancers topics women to stress and the potential dangers of most cancers remedy—surgical procedure, chemotherapy, and radiation—with none advantages.
The process pressure estimates that no less than one in eight tumors detected by mammography would never have spread and that for each lady whose life is saved by mammography, two or three will probably be handled with out good purpose.
Factoring In Your Breast Cancer Risks
Your strategy to breast most cancers screening ought to rely largely on how possible you’re to develop breast most cancers, Lipman says.
The greater your danger, the extra aggressive it’s your decision to be—by, for instance, beginning at age 40 or 45 as an alternative of 50 or getting screened as soon as per yr as an alternative of each two years.
The most essential danger elements embrace:
• A household historical past of breast most cancers.
• A private historical past of noncancerous breast circumstances, together with atypical hyperplasia or dense breasts.
• Menstrual durations that began earlier than age 12 or continued after 55, or not having a youngster earlier than 30.
• A historical past of hormone alternative remedy.
• Obesity, smoking, or extreme alcohol consumption.
• A historical past of multiple chest X-rays to diagnose, for instance, pneumonia or an damage.
four Key Questions to Consider
Below are the questions to contemplate, the positions of main health teams on every concern, and the recommendation of our specialists.
1. When Should You Start Screening?
American College of Obstetricians and Gynecologists: 40
American Cancer Society: 45
U.S. Preventive Services Task Force: 50
What to know: Breast most cancers turns into far more widespread after age 50, and beginning screenings sooner will increase the prospect of false alarms and, probably, pointless remedy. On the opposite hand, cancers that develop earlier than menopause have a tendency to be extra aggressive, making it extra necessary to catch them early.
CR’s take: The extra danger elements you’ve for breast most cancers, the extra affordable it’s to begin having mammograms in your 40s.
2. How Often Should You Have a Mammogram?
American College of Obstetricians and Gynecologists: Every yr.
American Cancer Society: Every yr from age 45 to 54, then each two years.
U.S. Preventive Services Task Force: Every two years.
What to know: Breast most cancers that seems earlier than menopause tends to unfold quicker. But frequent checks make false alarms and pointless remedy extra doubtless.
CR’s take: If you decide to display in your 40s since you are at excessive danger, annual checks make sense, switching to checks each different yr if you attain age 50 or so. People who begin screening of their 50s could also be higher off with testing each different yr, Lipman says.
three. When Should You Stop?
American College of Obstetricians and Gynecologists: Women 75 and older ought to speak with their physician about whether or not testing continues to make sense for them.
American Cancer Society: Continue so long as you’ve gotten a life expectancy of 10 or extra years.
U.S. Preventive Services Task Force: 74
What to know: There’s little onerous proof for the advantages of breast most cancers screening in women 75 and older. Although researchers know that about a quarter of breast most cancers deaths happen in women older than that, additionally they say that the older and sicker you’re, the much less probably it’s that mammography will prolong your life.
CR’s take: The American Cancer Society’s recommendation to think about your general health and life expectancy is sensible. A lady already recognized with a totally different sort of most cancers or coping with one other critical health drawback—corresponding to continual obstructive pulmonary illness or coronary heart failure—may need to focus extra on managing these issues. Someone in good health, nevertheless, may favor to proceed screening, particularly if she has danger elements for breast most cancers, Lipman says.
four. What About Breast Exams?
American College of Obstetricians and Gynecologists: Every yr beginning at 19.
American Cancer Society: Not really helpful.
U.S. Preventive Services Task Force: Not sufficient proof for or towards to make a suggestion.
What to know: Though having your physician verify your breasts for lumps (or doing so your self) could seem smart, little analysis backs up the follow, Lipman notes. Instead, these exams might create nervousness and lead to useless follow-up exams.
CR’s take: They make most sense for women at excessive danger. However, for those who discover one thing irregular, inform your physician.
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