American College of Radiology Supports Starting Mammograms at 40

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Two important radiology professional organizations -- the American College of Radiology (ACR) and the Society of Breast Imaging (SBI) -- have released recommendations on breast cancer screening. The recommendations were published in the January 2010 issue of The Journal of the American College of Radiology.

The recommendations say:

  • Women with average breast cancer risk should start annual mammograms at age 40.
  • Women with a much higher-than-average risk of breast cancer should start breast cancer screening at least by age 30, but not before age 25.
  • Women with a 20% or higher risk of breast cancer are considered to be at much higher-than-average risk. This includes women with an abnormal breast cancer gene (BRCA1 or BRCA2).
  • Women at much higher-than-average risk need a customized screening plan; this custom plan might include breast ultrasound and breast MRI as well as an annual mammogram.
  • Ultrasound (in addition to an annual mammogram) should be strongly considered as a screening tool for women at higher-than-average risk with dense breasts.

These recommendations are much the same as current breast cancer screening recommendations, but are different from guideline changes recommended by the U.S. Preventive Services Task Force in November 2009. The task force recommended:

  • Screening mammograms for women with average breast cancer risk should start at age 50, rather than 40.
  • Only women at very high risk should start breast cancer screening younger than 50.
  • Mammograms should be done every other year instead of every year.
  • Women older than 75 don't need mammograms.

These recommended changes sparked intense discussion and debate. Still, the good news is that most medical professionals and policy experts rejected the changes. salutes the ACR and SBI for objecting to any changes to current breast cancer screening guidelines.

Like many in the community, you may have questions about the debate triggered by the task force recommendations. offers information about the recommendations, including how they came about, how they might influence screening in the future, and what they mean for women today.

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