Understanding the New Breast Cancer Screening Guidelines (pegged to Breast Cancer Awareness Month)

Understanding the New Breast Cancer Screening Guidelines (pegged to Breast Cancer Awareness Month)

October is National Breast Cancer Awareness Month, and OB/GYNs Dr. Daniel Esteves and Dr. Tania Luga and their team are taking this opportunity to inform you about the new breast cancer screening guidelines as part of your well woman treatment.

What is a mammogram?

There’s only so much information a doctor can glean from a hands-on breast examination, which is why mammograms are used. A mammogram is basically an X-ray image of the breast.

A screening mammogram is the type used to check for breast cancer in women with no signs or symptoms of the disease. The test usually involves two or more X-ray images of each breast. X-rays often make it possible to detect tumors that can’t be felt on a breast exam. Screening mammograms can also find microcalcifications (tiny deposits of calcium) that may indicate the presence of breast cancer.

A diagnostic mammogram is the type used to check for breast cancer after a lump has been found or you develop another potential symptom of the disease, such as breast pain, nipple discharge, thickening of the breast skin, or a change in breast size/shape. These could be signs of cancer or may be related to a benign condition, hence the need for the test.

A diagnostic mammogram can also be used to further evaluate any changes found during a screening mammogram or to view breast tissue when it’s difficult to obtain a screening mammogram, such as if you have breast implants. Women with dense breast tissue may also benefit from a diagnostic mammogram.

Both types of mammograms use the same machines. However, a diagnostic mammogram takes longer to perform, and the total dose of radiation you receive is higher, because more X-rays are needed to obtain views from multiple angles. The tech administering the test may also magnify a suspicious area to produce a more detailed picture that helps the doctor make an accurate diagnosis.

The new breast cancer screening guidelines

In the last decade, different doctors and medical organizations had different guidelines regarding the best age at which to start breast cancer screening. The result was confusion on the part of the women being screened and the doctors themselves, as the “right” age ranged anywhere from 40-50 years old. These recommendations were based on statistical evaluations that weighed the risk/benefit and cost effectiveness of early screening.

In May 2023, though, the US Preventive Services Task Force updated its guidelines, lowering the minimum recommended age for screening mammograms from 50 to 40, based on recent research by the National Cancer Institute, which found that breast cancer is becoming more common among women aged 40-49 and increased at a rate of 2% per year, on average, from 2015-2019. It also recommended that women get a mammogram every other year from ages 40-74.

In revising its recommendations, the USPSTF’s guidelines are now aligned more closely with other groups’ recommendations. Most organizations recommend women be offered the choice to start screening at age 40. What has not changed is that the USPSTF didn’t change its recommendation that women be screened every other year, which puts it at odds with other groups recommending annual screening.

Two more things came out of the revision. First, the USPSTF highlighted the need for more research into screening disparities faced by different racial groups and into the benefits of breast ultrasound and MRI for those with dense breasts.

Second, the task force noted it didn’t have sufficient data from studies to make specific recommendations about whether women 75 and older should be screened, leaving that discussion to the patient and prescribing doctor.

Has it been a while since you’ve had a mammogram? Have you noticed any suspicious symptoms? Then it’s time to come into the office of Dr. Daniel Esteves for a breast exam and mammogram referral. To schedule, call the office at 770-676-5878, or book your appointment online today.

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