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Returning to past, US recommends women over 40 to have mammography

May 13, 2023

WASHINGTON D.C.: Reflecting improved diagnostic technology and treatment, a guideline update from the US Preventive Services Task Force proposed that women at average risk for breast cancer should begin receiving screening mammograms every other year beginning at age 40.

The update reverses a controversial recommendation made by the panel in 2009, which advised against routine mammograms for women in their 40s and said biennial screening should start at age 50, except for exceptional circumstances.

“At that time, the net benefit of mammography screening for women in their 40s, minus the potential harms, was small. A lot of things have changed since then,” said Dr. Carol Mangione, immediate past chair of the Preventive Services Task Force and current chair of the department of medicine at the David Geffen School of Medicine at the University of California, as quoted by Reuters.

Breast cancer rates in younger women have been rising, digital mammography advances have improved their accuracy, and better treatments are resulting in improved survival, she added.

“New computer models suggest that if biennial screening started at age 40 instead of age 50, and if everyone who is eligible got a mammogram, breast cancer mortality in the US would be reduced by 20 percent,” Mangione said.

The recommendation does not apply to people with a personal history of breast cancer, a very high risk due to a certain genetic predisposition or a history of high-dose radiation therapy to their chest at a young age, or a lesion on previous biopsies.

It also does not change related insurance coverage for patients, as US insurance companies are legally required to fully cover annual mammograms for women over the age of 40, the panel said.

Meanwhile, American Cancer Society Chief Scientific Officer Dr. William Dahut lauded the recommendations to begin screening at age 40.

In a statement, American College of Obstetricians and Gynecologists spokesperson Dr. Christopher M. Zahn said, “The ACOG has long asserted that regular screening via mammography starting at 40 years reduces breast cancer mortality in those without additional risk factors.”

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