Guidelines Delay Start of Mammograms to Age 50, Then Every Other Year

Nov. 17 -- MONDAY, Nov. 16 (HealthDay News) -- Women don't need to start having mammograms to screen for breast cancer until they're 50, and they only need to have those exams every other year, new government guidelines suggest.

Also, breast self-exams, which women have been urged to do routinely, have not helped lower the death rate from breast cancer, the guidelines add.

Not all agree with the revised recommendations, however.

Released Monday by the U.S. Preventive Services Task Force, the new guidelines are sparking debate and disagreement among breast cancer experts.

"Not screening all women in their 40s and every other year in their 50s is an opportunity to miss some cancer and miss saving lives," said Dr. Elizabeth Fontham, dean of the Louisiana School of Public Health and the national volunteer president for the American Cancer Society. "I certainly think it is going to confuse women, and that's unfortunate."

The American College of Radiology called the guidelines "a step backward," and added that they "represent a significant harm to women's health."

However, a spokeswoman for the task force that put together the new recommendations said the guidelines are the result of an analysis that compared benefits and risks -- early detection and reduced breast cancer deaths, for instance, vs. false positive results (indication of breast cancer when none is actually present), which can cause anxiety and make more testing necessary.

Specifically, the guidelines:

• Recommend against routine screening mammography in women aged 40 to 49.Though other groups strongly recommend annual mammography beginning at age 40 for women at average risk for breast cancer, the guidelines suggest that when women reach 40 they should talk to their doctor about the best time to start regular, every-other-year mammography.
• Recommend that women aged 50 to 74 years old have screening mammograms every other year rather than annually.
• Say that not enough data exist to make a recommendation based on benefits vs. harms for women 75 and older.
• Recommend against teaching women breast self-examination because the evidence does not show it reduces deaths from breast cancer.
• Say that not enough evidence exists to assess the value of clinical breast exams done by a health-care provider for women aged 40 and older.