From Confusion to Clarity: New Mammogram Guidelines Explained!

Amie Newman

Last week, the federal government released re-adjusted guidelines on breast cancer screenings, including mammograms and self-examination causing frustration, confusion and anger throughout the women's health community. Our Bodies, Our Blog explains. 

Last week, the federal government released re-adjusted guidelines on breast cancer screenings, including mammograms and self-examination.

The new guidelines state that instead of receiving yearly mammograms beginning at age 40, women can now wait until 50 years old to begin the annual screenings. But the new recommendations set off a firestorm of frustration from particular groups like the American Cancer Society and caused confusion as well. There are claims that these new guidelines will put women in greater danger, particularly African-American women, who have the highest rate of death from breast cancer and are more likely to develop breast cancer before age 40. 

The guidelines are clearly controversial with the debate focusing on whether or not breast cancer screenings at an earlier age are statistically helpful, whether the risk of exposure to radiation and the chances of false-positives and misdiagnoses are great enough to warrant this change or why the many women’s lives who have been saved by early detection and early screenings are not reason enough to keep the guidelines status quo.

So, what’s a woman to do?

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Our Bodies, Our Blogs does an excellent job at breaking down the new guidelines: what they mean, why there were re-adjusted and how a woman can evaluate what’s best for her given the new landscape.

In her post, New Mammogram Guidelines Are Causing Confusion, But Here’s Why They Make Sense, Christine Cupaiulo writes:

But a number of women’s health organizations, including Our Bodies Ourselves, the National Women’s Health Network and Breast Cancer Action,
for years have warned that regular mammograms do not necessarily
decrease a women’s risk of death. Premenopausal women in particular are
urged to consider the risks and benefits.

Cupaiulo confirms that far from disempowering women to take care of their health, these new guidelines align with the World Health Organization’s recommendations, and may help women to have a clearer understanding of the health impact of mammograms:

I don’t believe the new guidelines are politically motivated, nor are they “patronizing
to women simply because they call into question the stress related to
biopsies and false positive results. Rather, the guidelines provide a
useful framework for helping each of us to decide when is the best time
to begin screenings and the intervals at which they should be repeated.

The guidelines are in sync with international recommendations; the World Health Organization
recommends starting screening at age 50, and in Europe, mammograms are
given to post-menopausal women every other year and detection rates are
similar to the United States. During an interview on MSNBC
on Tuesday, breast cancer expert Dr. Susan Love said the government’s
guidelines bring us into line with the rest of the world and with
current research. (Read more at her blog.)

In response to the claims that these new guidelines will ultimately affect insurance coverage for mammograms, Cupaiulo quotes a New York Times recent article which, in part, explains:

The guidelines are not expected to have an immediate effect on
insurance coverage but should make health plans less likely to
aggressively prompt women in their 40s to have mammograms and older
women to have the test annually.

But, here’s the thing. Cupaiulo is careful to note that there is no reason why women should not be encouraged to continue to make their own decisions they feel are right and best for their health and lives. 

If you’re reading this and thinking you still want to keep that scheduled mammogram, you should certainly do so.

“No one is saying that women should not be screened in their 40s,” said Petitti, the task force vice chair. [Ed. note: of the advisory group that released the new guidelines] “We’re saying there needs to be a discussion between women and their doctors.”

Dr. Amy Abernethy of the Duke Comprehensive Cancer Center said she agrees with updated recommendations.

Tara Parker Pope, writing at The New York Times blog in Our bodies, Our Breast Exam also quotes Dr. Petiti, 

Dr. Petitti also wanted to clarify that the new recommendations did
not tell women to stop doing breast self-exams, just like they did not
tell women not to have mammograms until age 50. Rather, the advisory
group recommends against routine mammography in younger women.

“Nothing in our recommendations says that a woman who finds a lump shouldn’t go to her physician,” Dr. Petitti said.

For some women for whom the anxiety of false-positives, exposure to radiation over a span of years or opening themselves up to surgery to remove a lump that may never have been harmful in the first place, these recommendations may elicit a sigh of relief. But for many others, the personal experience of losing someone close to  breast cancer or receiving a diagnosis of breast cancer via a mammogram at an early age, these new guidelines don’t feel right. 

Read more at Our Bodies, Our Blog

 

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