This story originally appeared on The Local Moms Network.
Recently, the U.S. Preventative Services Task Forces announced that women with average risk should start getting mammograms at age 40 – moved up ten years from age 50.
To understand what was behind this change in recommendation and who it affects most, The Local Moms Network turned to Melanie Lynch, M.D., Director of Breast Surgery for Smilow Cancer Hospital in CT and Assistant Professor of Surgery (oncology) with Yale School of Medicine.
What are the biggest takeaways here?
The USPHTF have changed their recommended breast cancer screening guidelines to include women in their 40’s. This change now aligns the USPHTF with the American College of Radiology, the American College of Surgeons, the American Society of Breast Surgeons, and the National Cancer Center Network, who all recommend breast cancer screening with mammography and tomosynthesis for women starting at age 40.
Reasons for this change:
- The recognition of the increasing incidence of breast cancer in younger women
- The likelihood of more aggressive tumor biology in younger women, associated with more advanced stage at diagnosis and need for chemotherapy.
- Delaying screening until age 50 adversely impacts Black, Asian and Hispanic women, as one-third of breast cancer in these racial groups is diagnosed under age 50.
- We are moving away from age-based screening guidelines to risk based screening. Every woman is now recommended to have a cancer risk assessment at age 30. This risk assessment should include personal risk factors, family history, estimation of 5 year and lifetime risk using validated risk models and recommendation for age to start screening and the modality of screening (mammogram, US, breast MRI).
What is defined as average risk and who should be screened earlier than 40?
It is easier to identify women at increased risk of breast cancer. These risk groups include:
- Women with thoracic radiation therapy at age younger than 30.
- Women with prior breast biopsy demonstrating atypia or lobular carcinoma in situ.
- Women with a significant family history of breast or ovarian cancer or other hereditary cancer syndrome.
- Women with estimated lifetime risk of breast cancer > 20% using statistical models that take into account family history, prior biopsies, breast density, age at first birth and obesity, along with other risk factors.
Any woman who does not fit into one of these increased risk groups is considered average risk, with estimated lifetime risk of breast cancer of 10%. Women who have a family history of breast cancer should begin screening at an age 10 years younger than the youngest age of breast cancer diagnosis in their family. Women who have a known breast cancer hereditary cancer syndrome should begin screening at age 25 or 30, depending on the cancer syndrome.
Any tips for someone nervous for their first mammogram?
Just do it. Breathe deep and stay in the moment. This is an important way to take care of yourself and your family. Make sure to treat yourself afterwards!
About the Expert
Melanie Lynch, M.D., is Director of Breast Surgery for Smilow Cancer Hospital in Fairfield and Trumbull, CT. She is also the Medical Director of the Norma Pfriem Breast Center and an Assistant Professor of Surgery (oncology) with Yale School of Medicine.
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