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Mammography at age 40?

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When a U.S. government task force recommended that women wait until their 50s to get their first mammogram and stop breast self-exams in 2009, the dramatic reversal in breast cancer screening guidelines last year sparked immediate debate.

And has left many women in their 40s confused about whether to schedule the annual screenings.

Today, the American Cancer Society (ACS), American Congress of Obstetricians and Gynecologists and American College of Radiology are standing by their guidelines advising annual mammograms starting at age 40 and regular breast exams.

According to the U.S. Preventive Services Task Force (USPSTF), women who have screening mammograms die of breast cancer less frequently than do women who don't get mammograms. However, the USPSTF says the benefits of screening mammograms don't outweigh the harms for women ages 40 to 49. Potential harms may include false-positive results that lead to unneeded breast biopsies and accompanying anxiety and distress.

Regardless of their differences, both groups agree that women should talk to their doctors for guidance based on their individual medical history and other factors. A woman’s decision to begin mammograms at age 40 – or older – should be an individual one, and it should be based on a thorough review of personal history and educated discussions with her primary care physician and gynecologist.

A Gyn-Oncologist’s View

To James Fiorica, MD, a gynecological oncologist whose practice is devoted solely to treating women’s cancer, the choice is crystal clear.

“In my profession, too often we see cancers at an advanced stage,” said Fiorica, who serves as medical director of Sarasota Memorial’s Women’s Cancer Programs. “We all wish we had the opportunity to discover and treat it earlier.”

He advises women to stay informed, continue monthly breast self-exams and, starting at age 40 (or younger for those at high risk), get annual mammograms.

He points out that most breast cancer occurs in women without family histories, and about 25 percent occurs in women under the age of 50. In younger women particularly, he added, breast cancer often is more aggressive. Catching it early, before it has a chance to spread to other areas of the body, is critical to survival.

“True, it might lead to more tests and more biopsies, but if you can save lives, isn’t it worth it?”

Media Contact: Kim Savage, 917-6271

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