Women’s Health Specialists Say Mammograms Should Start at 40

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The American College of Obstetricians and Gynecologists (ACOG) has issued new breast cancer screening guidelines for doctors who care for women. The guidelines will be published in the August 2011 issue of Obstetrics & Gynecology.

The guidelines recommend:

  • screening mammograms once per year, starting at age 40, for women with average breast cancer risk
  • encouraging young women to do regular breast self-exams starting at age 20
  • breast exams by a doctor or other healthcare professional every 1 to 3 years for women aged 20 to 39, and every year for women 40 and older

The ACOG mammogram guidelines are the same as mammogram guidelines from the American Cancer Society and the National Comprehensive Cancer Network. The National Cancer Institute still recommends screening mammograms every 1 to 2 years (instead of every year) for women aged 40 to 49, then every year starting at age 50.

The value of routine mammogram screening was questioned in November 2009 when the U.S. Preventive Services Task Force (USPSTF) recommended that routine screening mammograms for women with an average risk of breast cancer should start at age 50 instead of age 40. The recommended changes were very controversial and were not adopted.

When developing the new ACOG guidelines, committee members noted that although breast cancers are less common in younger women compared to older women, research shows that breast cancers in younger women tend to grow almost twice as fast on average as breast cancers in older women:

  • In a woman in her 40s, an average breast cancer grows from small with no symptoms to large enough to be felt with symptoms over 2 to 2.5 years.
  • In a woman older than 70, an average breast cancer grows from small with no symptoms to large enough to be felt with symptoms over about 4 years.

Because of the faster average growth of breast cancers in younger women, the committee members felt that screening EVERY year for ALL women -- including women aged 40 to 50 -- makes sense. The committee members believe that breast cancer screening every year (instead of every 1 to 2 years) in women aged 40 to 50 will improve the likelihood of detecting breast cancer at an early and more treatable stage. This will allow the women to start treatment sooner and reduce the risk of the cancer's spread.

If you're 40 or older and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. If your breast cancer risk is higher than average, you may want to talk to your doctor about a more aggressive breast cancer screening plan that makes the most sense for your particular situation.

There's only one of you and you deserve the best care possible. Don't let any obstacles get in the way of your regular screening mammograms.

  • If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
  • If you're having problems scheduling a mammogram, call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
  • If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.

For more information on mammograms and other tests to detect breast cancer, visit the Breastcancer.org Screening and Testing pages.

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