Are you unsure of when to get a mammogram? You’re not alone.
New guidelines on mammograms and varying advice on when to start screening and how often to have it have left some women feeling angry and confused.
On Tuesday, the American Cancer Society announced a major shift, recommending that most women have an annual mammogram starting at age 45, rather than the previously recommended age of 40. It said women 55 and older should cut back to being screened every other year.
The advice differs from other major groups.
An influential panel, the U.S. Preventive Services Task Force, recommends that most women can safely wait to start mammography until age 50 and that they should have the test every other year. The American College of Obstetricians and Gynecologists recommends a screening mammogram starting at age 40 every one to two years, and annually for women 50 and up.
The cancer society noted that mammograms aren’t perfect and do have risks, and said the guideline for the age of 45 is when the “benefits substantially outweigh the harms.”
With many women wondering how to proceed, TODAY turned to Dr. Susan Drossman, a diagnostic radiologist, who shared her thoughts on Wednesday with Savannah Guthrie.
The various medical groups have differing recommendations.
“As a doctor and as a female, I am angered and I am concerned. I think there’s a lot of confusion about how often women should be screened and when they should begin.
“I think the American Cancer Society has tried to set up guidelines where we’re moving away from a one-size-fits-all type of screening to a more personalized or individualized type of screening."
“The guidelines are directed toward the average-risk woman. That is, women who have no family history, no genetic predisposition. But in those patients, that’s where we find most of our breast cancers.
“Only 15 percent of the cancers that we find actually have a family history. The remainder are all sporadic events. And now, they’re asking us to take these patients, start screening later. That means we’re going to find breast cancers much larger.”
Drossman answers our questions:
For years, women have been screened starting at age 40. What is the downside of screening at the earlier age?
“What they say are the downsides and what they are trying to move away from are what we call false positives and over-diagnosis."
What happens with a false positive?
“These are finding things on mammography where we need to call a patient back for either an additional view or an ultrasound. And that really only happens in 10 percent of cases. With our new digital imaging, we are much better at decreasing the number of false positives.
“But still, yes, 1 to 2 percent of patients will wind up with a biopsy. But I can tell you in my practice and generally speaking to physicians that take care of patients, we are able to with those additional views, limit patients having biopsies, and when they have a biopsy and it’s benign, they breathe a sigh of relief. And, no one would want to miss finding a breast cancer early."
Will mammograms be covered by insurance companies in light of the revised recommendation?
“Right now, these are just guidelines and nothing is written in stone. Talk to your doctor. We don’t know what insurance companies will do. There’s a lot of uncertainty, and most of us are very angry.”
TODAY.com contributor Lisa A. Flam is a news and lifestyles reporter in New York. Follow her on Twitter.