Unravelling Conflicting Advice on Mammograms

As we talk about breast cancer awareness this October, women are now hearing “Get your mammogram” and “Do you really need a mammogram?”. Who should they listen to?

For 30 years, October has been National Breast Cancer Awareness Month. Even the NFL supports those efforts through their initiative “Pink October” when NFL players, coaches, and referees wear pink to promote breast cancer awareness and encourage annual screenings as a preventive measure.

Ironically, this October brought a new national debate concerning when and how often women should be screened. The conversation seemed to turn from “Get your mammogram” to “Do you really need a mammogram?” Understandably, women are confused and frustrated.

More than half of women ages 40 and older believe an annual mammogram is just what the doctor ordered, but even the doctor is wondering what’s best now that the U.S. Preventive Service Task Force announced new guidelines recommending first mammograms at age 50 and every other year after that.

Several organizations, including the American Cancer Society, have put forth guidelines that vary significantly and are causing angst among women who are trying to do what is best to protect themselves from a disease that affects one in eight. But what is best?

No one knows exactly why some women get breast cancer, but there are a number of known risk factors, such as age, heredity, weight, use of hormones, alcohol use, and childlessness. Truth is, it is impossible for any set of guidelines to accurately advise every woman. Plus, guidelines by definition are very general advice, not a universal prevention plan that can be applied to everyone.

The most responsible approach for any woman is to discuss her situation with her personal physician. He or she can help determine if a patient is at higher risk than average and when it is reasonable to start screening. Those at higher risk should probably take advantage of earlier and more frequent screenings. Women considered low-risk might prefer to avoid what may be unnecessary medical procedures, or they may be influenced by experiences of friends or family who have fought breast cancer and choose more frequent checks for their own peace of mind.

Either way, the decision regarding when to screen and how often is one that each patient should make in concert with her physician, using national guidelines as part of the information to consider.