How Often Should I Get a Mammogram?

Depending On Your Family History, the Answer Can Be Complicated

Breast cancer/ mammogram. Credit: Chicago Tribune / Contributor / Getty Images

In November 2009, The U.S. Preventative Services Task Force (USPSTF), a branch of the U.S. Department of Health and Human Services, updated its recommendations on mammograms and breast cancer screenings. Previous standards had stated that women should be screened for breast cancer annually, starting at age 40. The new standards changed this guideline. The recommendation that women between 40 and 49 years old should not have annual mammograms, but should discuss their screening with their doctors, is still extremely controversial and hotly debated.

These updated mammogram guidelines have been adopted by some and continue to be rejected by others.

Why Are Mammograms Important?

The U. S. Health and Human Services Department says that the purpose of screening mammograms is to detect any issues in the breast as early as possible and get it appropriately diagnosed. It's the best way to find small, early-stage breast cancers, even before you can feel a lump. Smaller tumors require less treatment and survival rates are as high as 98% for early-stage breast cancer.

What Are The Recommendations for Women In Their Forties?

The updated guidelines now recommend women age 40 and older have a mammogram every 1 to 2 years and the decision to screen annually is up to you and your doctor. They state that doctors should "take patient context into account, including the patient's values regarding specific benefits and harms." However, if you are under 50, have a family history of breast or ovarian cancer, find a lump while doing your breast self exam, or have nipple changes, see your doctor for a clinical breast exam and a referral for a diagnostic mammogram even if you had a screening mammogram the previous year.

What About Women Aged 50-74?

All of the government and non-profit institutions that make recommendations about mammograms agree that women aged 50 to 74 should have breast screening every two years. For women with a strong family history of cancer, or who have had a recent bout with breast cancer, your doctor may want you to be screened yearly.

Your risk of breast cancer increases as you age. Women who are age 55 or older account for 2 out of every 3 cases of invasive breast cancer. If you find lumps or bumps between regularly scheduled mammograms, have them checked out, and ask if you should have diagnostic breast imaging done.

Should Women Over 75 Get Mammograms?

When you're 75 and over, decisions like whether or not to have a screening mammogram should be discussed with your doctor and weighed against any other health issues you may have. There is not enough clinical evidence on the potential harm or benefits of having a mammogram past age 74, so you will need to consider your own health history before deciding. Even if you are in good health and expected to live to a good old age, your doctor may be unwilling to refer you for a mammogram, even though it's likely that Medicare will help pay for it.

Choose Your Mammogram Date Wisely

Younger women should schedule a mammogram during the first 14 days of their menstrual cycle, to reduce pain and increase accuracy.

Prepare carefully; remember not to use deodorant that day and wear a comfortable bra under a two-piece outfit. Two images of each breast will be taken to be sure that as much breast tissue as possible is included. Digital mammography is currently being used, which requires low amounts of radiation and shorter exposures.

Hands-On Screening

You can still do your monthly breast self-exam, to keep in touch with changes in your breasts. Your breasts will age along with the rest of your body, so allow for cyclical and natural changes. If you are concerned about a lump, bump, breast pain, a strange rash, a change of skin color or nipple discharge, visit your doctor for a clinical breast exam. Remember that between 80 and 85% of all breast lumps are benign and having a mammogram can help rule out breast cancer.

Sources:

Breast Cancer: Causes, Risk Factors, and Prevention: Aging. American Cancer Society. Last Revised: 09/17/2010.

Breast Cancer: Kinds of screening tests. Centers for Disease Control and Prevention. Last updated: September 1, 2010.

Diagnosis of breast disease. Institute for Clinical Systems Improvement (ICSI). U. S. Department for Health and Human Services. Last Updated: June 23, 2010.

Factors Influencing Mammography Use Among Women in Medicare Managed Care. Judith K. Barr, Susan Reisine, Yun Wang, Eric F. Holmboe, Karin L. Cohen, Thomas J. Van Hoof, Thomas P. Meehan. Health Care Financing Review, Summer, 2001.

Mammograms. National Cancer Institute. Reviewed: 08/14/2009.

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