When to Get a Mammogram

For the past 50 years women have been urged to have regular mammograms—breast X-rays that help healthcare providers find suspicious lumps. But experts have disagreed about exactly when women should begin to get this breast cancer screening test.

The U.S. Preventive Services Task Force (USPSTF) says women at average risk of breast cancer should start screenings at age 50, and the American Cancer Society recommends starting at 45. And up until recently, the American College of Obstetricians and Gynecologists (ACOG) said all women should start having regular mammograms at 40.

Now, a new update to ACOG’s recommendations walks back from that one-size-fits-all approach. Instead, they say women should start screening no later than age 50 but should have the choice to begin sooner—in their 40s.

The new recommendations also say that individual women and their doctors can decide whether to screen every year or every two years.

ACOG’s change acknowledges that all of the potentially conflicting screening strategies have merit, says Chris Zahn, M.D., ACOG’s vice president for practice activities. Though all three groups work from the same body of research, the results are open to different interpretations that can lead to differing advice, he says.

ACOG’s update resolves some of that conflict by emphasizing the importance of a woman’s individual decision-making within a set of rough guidelines, rather than telling women exactly what to do.

“There has been so much confusion around the guidelines and how different they are,” says Lisa Schwartz, M.D., professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice. Schwartz wasn’t involved with crafting the new guideline.

This change, which suggests that the mishmash of advice is “starting to come together,” Schwartz says, should help ease some of that confusion for women wondering what to do.

“Women trying to decide when to get a mammogram need to understand the evidence, and they…

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