Last Fall, the USPSTF released controversial new mammogram guidelines changing recommendations for mammograms to start at age 50 rather than 40 and recommending mammograms every 2 years rather than annually. This was met with national public and professional outrage and subsequently many physician groups and the American Cancer Society came out against these guidelines. In addition, the Senate disagreed with guidelines and approved an amendment that would require health insurance companies to cover mammograms for women aged 40-49.
Suffice it to say, I do not agree with these USPSTF guidelines. I recommend that women get a baseline digital mammogram between the ages of 35-40 and then annually beginning at age 40. Women at high risk for breast cancer (personal history, dense breasts, strong family history, and/or carrier of BRCA type gene mutations predisposing to breast cancer) can talk with their physicians about diagnostic mammograms, MRI’s and additional testing.
These new guidelines also advised against self breast exams stating they do not reduce mortality and may cause psychological harm and unnecessary follow-up tests. While this may be true, and may help women who are not good about self exams to feel a bit better, I see no reason
for women who are performing self breast exams to stop. We all know of many women who have detected breast cancer by doing this. And I would guess that most women would be willing to take the risk of having a follow-up ultrasound, mammogram, or biopsy and a few days of anxiety in order to not miss a case of cancer.
If you are behind on your mammogram, please take a moment right now to call and make your appointment. Your career or family may be keeping you too busy right now to feel like you can take the time, but I urge you to find the time for yourself. You are important and worth it. As a reward, book yourself a pedicure, lunch date, or pick up a latte in conjunction with your appointment for doing such a good job and taking charge of your health!
Mona Saint M.D., M.P.H. is a board certified Ob/Gyn and a mother of two young boys. She has won awards of excellence in gynecologic surgery and teaching, and she continually receives the highest ratings in patient satisfaction surveys. Most of all, she is appreciated for her down to earth and easy to understand explanations of complex medical questions and her empathetic style.
{ 1 comment }
Will Winter, M.D. 04.27.10 at 8:34 pm
Mona, I was just perusing facebook and saw you in our class group. Your blog title was posted so I wanted to see it.
I like your article. I am a child psychiatrist. One day, a mother and son that I have known for about 2 yrs came in. She told me that her boyfriend found a lump which turned out to be breast CA. This woman is 39, young and vibrant.
I know that this is just one case and one case does not a study make. But each person is special and to deny a diagnostic test that can save the life of a patient you know seems inhumane, no matter what the price. It is easy to be an academic in an ivory tower and crunch numbers and look for the right answer from an economic point of view. But when you’re here in the trenches with the real people one can really see the conflict between financial efficiency and being humane.
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