The American Cancer Society released new guidelines for mammograms today that strongly recommend women start having annual mammograms at age 45, then transition to mammograms every other year starting at age 55, continuing for as long as they are healthy and have at least a 10-year life expectancy.
The ACS says women who want annual screenings earlier, at age 40, or after age 55 should have the opportunity. The cancer society also recommended against clinical breast exams by doctors, which have long been part of breast health.
Dr. Therese Bevers is medical director for MD Anderson Cancer Center’s Cancer Prevention Center and chair of the National Comprehensive Cancer Network’s guidelines panels on breast cancer screening and diagnosis and breast cancer risk reduction. She speaks with Here & Now‘s Robin Young about the new screening guidelines.
Interview Highlights: Dr. Therese Bevers
Why aren’t annual breast exams recommended?
“Well, that is a very dramatic change from their previous recommendation and the recommendation from NCCN and MD Anderson. There’s no new data that really supports making such a dramatic change. The recommendation is based largely on the fact that there is not high-level data supporting doing or not doing breast exams, so they have taken the position that without data to support doing it, we should not do it. I think other organizations are taking the stance either that there’s no new data so why change recommendations from what we have been doing or maybe compromise in the middle and say it may be an optional modality.”
The guidelines suggest that women who want to get mammograms earlier, at age 40, should
“Absolutely. I think a big take-home point from these recommendations is that they have – by publishing these analysis – shown that screening women ages 40 to 69 results in fewer women dying from breast cancer. They also note that annual screening compared to every other year results in a larger mortality reduction. Their concern for women 40 to 44 is that there may be more false positives so the overall net balance of benefits and harms may not be as clear for every woman. But nonetheless, they do provide the opportunity for a woman to begin annual mammographic screening at age 40.”
On insurance providers and the new guidelines
“Actually, the ACS endorsed coverage for screening mammograms for a woman beginning at any age and at any screening interval and not going with the U.S. Preventive Services Task Force A or B recommendations. So basically with that recommendation, they are saying that if a woman wants to start at age 40 and have annual mammograms, as long as she has a 10-year life expectancy, that would be compliant with the guidelines and should be covered.”
This is not rationing, you can still do what is right for you
“Absolutely. They do give women the option to begin at age 40 and to have annual mammograms as long as they are getting screened and have a 10-year life expectancy. They’re just saying that some women may not feel that the balance of benefits in the 40 to 44 and over 55 warrant annual or beginning earlier.”
Correction: This story has been updated to clarify the age at which women should be able to get a mammogram if they want one, before the age of 45.
Guest
- Dr. Therese Bevers, medical director for MD Anderson Cancer Center’s Cancer Prevention Center, and chair of the National Comprehensive Cancer Network’s guidelines panels on breast cancer screening and diagnosis and breast cancer risk reduction.
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