Panel: Age 50 early enough to start mammograms

Image: National Cancer Institute

New recommendations from an expert panel advise that more harm than good may come from earlier screenings for breast cancer.

After years of being told that they should start having annual mammograms at age 40 to screen for breast cancer, new recommendations from an independent panel of experts say there’s no benefit to women at normal risk to starting screening before age 50.

Women ages 50 to 74 should be screened every two years, according to the U.S. Preventive Services Task Force, an independent panel of experts sponsored by the Agency for Healthcare Quality and Research, a government agency.

Women ages 40 to 49 who are at high risk for breast cancer should consult with their doctors about the best time to start biennial mammography screening, the panel said. It hasn’t made a recommendation on routine screening for women over age 74, citing a lack of evidence.

“The harms resulting from screening for breast cancer include psychological harms, unnecessary imaging tests and biopsies in women without cancer, and inconvenience due to false-positive screening results,” according to the report which also sites over diagnosis and “unnecessary earlier treatment of breast cancer that would have become clinically apparent but would not have shortened a woman's life” as well as radiation exposure from tests as considerations for the revised recommendations.

The panel’s recommendations appear in the November 17 Annals of Internal Medicine journal.

Organizations typically review their medical guidelines about every five years to take into account available research and new developments in their fields. The U.S. Preventive Services Task Force last updated its breast cancer screening guidelines in 2002.

The National Cancer Institute currently recommends that women age 40 and older have mammograms every one to two years and women at high risk for breast cancer should talk with their health care providers about whether to start mammograms before age 40 and how frequently they should have them.

The American Medical Association and the American Cancer Society currently recommend that women begin annual mammography at age 40.

According to the National Cancer Institute, women are considered to have a higher risk for developing breast cancer if they:

• had breast cancer previously
• have a close family member who has been diagnosed with the disease
• had abnormal cells detected through a biopsy
• started menstruating before age 12 or went through menopause after age 55
• had their first child after age 30 or never have a child
• took combination estrogen-progestin menopausal hormone therapy for more than 5 years
• have dense (as opposed to fatty) breasts
• had radiation therapy to the chest (including the breasts) before age 30
• took the drug diethylstilbestrol (DES) which was given to some pregnant women in the United States between 1940 and 1971
• are post-menopausal women and overweight or obese
• have been physically inactive throughout life
• abuse alcohol
• had changes in certain genes (very rare)