Important Information About the New Breast Screening Guidelines - Adventist HealthCare

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News Release

Media Contact: Tom Grant

Published on November 19, 2009

Health Advisory

Información en español

Important Information About the New Breast Screening Guidelines

On November 16, the U.S. Preventive Services Task Force released new guidelines for breast cancer screening for women. Many other well-respected organizations, such as the American Cancer Society and the American College of Radiology, have existing breast screening guidelines. The latest guidelines, which contradict the broadly accepted guidelines that are currently used, can create confusion and concern among women who are unsure about when and how to be screened for breast cancer.

Recently, U.S. Secretary of Health and Human Services, Kathleen Sebelius, responded to the new guidelines by saying that "Mammograms have always been an important life-saving tool in the fight against breast cancer and they still are today." Secretary Sebelius suggested that women talk to their doctors about their health history and ask questions to make decisions that are best for them. She also cautions that the panel's recommendations on mammograms don't dictate federal policy and won't change federal coverage.

Below, experts from Shady Grove Adventist Hospital and Washington Adventist Hospital provide answers to some important questions about the latest breast screening guidelines as well as information on other guidelines. In light of the latest recommendations, it becomes more apparent than ever that the decisions around when and how often to screen for breast cancer - either through mammograms or other techniques - should be made by a woman and her physician, and be based on the woman's risk factors and other health considerations.

What do the new breast exam guidelines recommend that is different?

The new guidelines from the U.S. Preventive Services Task Force recommend against routine mammograms for women between 40 and 49 years. The task force also recommends that women between 50 and 74 years receive mammograms every two years. Additionally, the task force recommends against clinicians teaching women how to perform breast self-exams.

Who created the new guidelines?

The new guidelines were created by the U.S. Preventive Services Task Force which consists of 16 health care experts from institutions, hospitals and medical schools around the country. Unfortunately, the panel did not include an oncologist.

How did the federal task force develop the new guidelines?

The federal task force guidelines on breast cancer screening are based on an analysis of data. The group reviewed data on the effectiveness of five types of breast screenings: film mammography, clinical breast exams, breast self-examination, digital mammography and magnetic resonance imaging. Additionally, the task force compared data on the benefits and harm of breast screenings and also compared expected health outcomes and resource requirements of starting and ending mammograms at different ages as well as annual versus biennial (every two years) mammograms.

If I am between 40 and 49, how do the new guidelines affect me?

The latest guidelines recommend against routine mammograms for women between 40 and 49 years of age. At this time, many of the national groups, such as the American Cancer Society (ACS) that have existing breast exam guidelines are not planning to change their guidelines based on the federal task force recommendations.

The current ACS guidelines recommend annual mammograms for women starting at age 40. The ACS also recommends self breast exams monthly (for all age groups) and clinical breast exams annually for women 40 and over, and every three years for women between 20 and 39 years. Again, the ACS has stated that it will not change its guidelines based on the federal task force recommendations.

A woman who falls into this age group (under 50) should discuss her individual health risks and benefits of mammograms and other breast exams with her physician at the time of her annual physical or check-up, or when she is due for her routine mammogram.

If I am 50 years or older, how do the new guidelines impact me?

The new guidelines recommended by the federal task force recommend mammograms every two years for women between 50 and 74 years. The task for does not recommend mammograms for women 75 and older.

As noted above, the current ACS guidelines recommend annual mammograms for all women over 50 years. All women who are 40 or older should talk to their doctor about their individual risk factors for breast cancer and their personal breast exam schedule.

Are self-breast exams still recommended?

Guidelines from the federal task force do not recommend breast self-exams. While breast self-exams may be less effective at finding breast cancer when compared (independently) to mammograms or other screening techniques, breast self-exams are an important way for a woman to become familiar with her body and to take a proactive role in her own health, know her body as well as note and report any changes. Also, there is no harm to this practice. Despite the latest recommendations, many medical experts still recommend that a woman perform monthly breast self-exams and contact her physician if she identifies anything unusual.

Do the latest guidelines on breast screening assess other forms of breast screening technology such as digital mammograms or MRIs?

The new federal task force guidelines on breast screening are mainly directed at film mammograms. Many hospitals in the Washington, DC area offer digital mammograms for patients. Another important tool in the overall approach to breast cancer screening and diagnosis is magnetic resonance imaging (MRI). The federal task force did not have enough evidence to make a recommendation about the use of digital mammograms (currently broadly available) or MRIs for breast screening. Patients and physicians should consider the lack of a recommendation for these important and effective screening options from the federal task force as well as the local availability of these modern screening options when making a decision about breast screening timing and format. 

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