Making Sense of Varying Mammography Guidelines

 Breast Cancer Awareness Month occurs every October, an always-busy time for our UCLA Breast Imaging Service because this national observance reminds many women to get their mammograms.
It also may have women asking, “How often should I have a mammogram?” Their uncertainty is understandable because the key organizations that publish guidelines — American Cancer Society, American College of Radiology, Society of Breast Imaging and United States Preventative Services Task Force — all vary in their recommendations. These differing opinions have led to confusion not only among women but also among their physicians.
Despite the different recommendations, ALL organizations agree that yearly screening mammograms save the most lives. However, the organizations disagree on how much emphasis to put on the potential harm from mammography.
Possible harm includes:
• Anxiety associated with false-positive (false alarm) results;
• Unnecessary breast biopsies;
• Concerns about radiation; and
• Over-diagnosis of breast cancer.
Both the American College of Radiology and the Society of Breast Imaging feel that saving the most lives is paramount and hence recommend yearly screening mammography beginning at age 40. The cancer society suggests that women hear about mammography’s benefits and possible harms, then decide when they would like to begin yearly mammograms, age 40 or 45, and whether they will continue with yearly screenings after age 54 or transition to biannual screenings.
Finally, the U.S. task force believes that the possible harms from mammography may outweigh the benefits and recommends mammography every two years for women 50-74. Given these differing opinions, women should understand that annual screening mammograms save the most lives, but also carry more risks for false positives that require additional evaluation, including possible biopsies.
At UCLA Health, we believe that “every month is breast-cancer awareness month.” I encourage you to discuss with your physician and close family members the benefits and risks of yearly mammograms to help guide you in making the best-informed decision for your health.
Dr. Anne Hoyt is section chief and medical director of Breast Imaging at UCLA Health. For more information about UCLA’s breast-imaging services in Santa Clarita, call 661-253-5858.