New Mammography Guidelines for Women
Women in Their 40s Should Discuss Risks, Benefits With Doctors, Says Physicians Group
April 2, 2007 -- The American College of Physicians today issued new
mammography guidelines for breast cancer screening for women in their 40s.
The guidelines boil down to this: Women in their 40s should work with their
doctors to gauge their personal breast cancer risk and to decide whether to get
mammography to screen for breast cancer.
If a woman in her 40s decides not to get a screening mammogram, she and her
doctor should revisit that decision every one to two years, states the American
College of Physicians (ACP).
In short, the ACP isn't making a one-size-fits-all recommendation. Instead,
the ACP says the decision should be tailored to each individual woman in her
"No simple recommendation applies to all women in their 40s," states
an editorial published with the guidelines in the Annals of Internal
The guidelines only apply to routine screening mammograms, not diagnostic
mammograms taken of specific breast lumps or other breast findings.
A team of experts reviewed 125 mammography studies for the ACP. They
included Katrina Armstrong, MD, MSCE, of the University of Pennsylvania.
"Screening mammography probably reduces breast cancer mortality in women
aged 40 to 49 years modestly," write Armstrong and colleagues.
They note that many women in their 40s will choose mammography for that
potential reduction in breast cancer death.
However, Armstrong's team notes that screening mammograms likely save more
lives in women aged 50 and older, since breast cancer becomes more common with
In addition, mammograms aren't perfect. They may miss a tumor or flag a
benign breast lump, leading to more tests and anxiety.
Mammograms also deliver a low dose of radiation, and it's not clear what the
long-term consequences of that may be over a lifetime, note Armstrong and
Many women find the mammography procedure uncomfortable. But in the reviewed
studies, few women said mammography pain would stop them from getting a
Women's breast cancer risk depends on age, family history, and many other
A woman in her 40s should gauge those risk factors with her doctor and
decide how she feels about getting mammography to screen for breast cancer,
"Because of the variation in benefits and harms associated with
screening mammography, we recommend tailoring the decision to screen women on
the basis of women's concerns about mammography and breast cancer, as well as
their risk for breast cancer," write Armstrong and colleagues.