CHICAGO — A radical change in advice about screening women for breast cancer was announced Tuesday.
Get screened earlier. It will save lives. For Black women it’s even more important.
After years telling women to wait until 50 for their first mammogram, the nation’s top doctors are urging women to back that up by a decade.
But some who devote their lives to finding breast cancer say even those recommendations don’t go far enough.
Dr. Sarah Friedewald is chief of breast imaging at Northwestern Medicine.
“One in six breast cancers occur in women in their 40s,” she said. “If we are screening these patients, we will find a cancer, smaller and more easily treatable.”
Friedewald said that’s the goal: find cancer early when it is most treatable.
“Information is power,” she said. “Come, get your mammogram, find out if there’s anything wrong. And if there is, it’s something we can address and potentially save lives.”
But for years the U.S. Preventive Services Task Force recommended beginning mammogram screening at age 50.
Now a change of heart. Tuesday nationwide members issued their revised guidelines saying women at average risk should get their screening mammogram at 40. But they said women only need those screenings every other year. One thousand women younger than 40 die each year from breast cancer and those on the front lines say while the change to 40 is a step in the right direction, the screenings should happen every year.
“We have always felt that the data show the most lives are saved, and that’s really our focus. The longer you increase the interval between screens, the more likely a cancer can grow and potentially be incurable,” Friedewald said.
And that’s especially true for Black women.
“Black women have an increase chance of developing a more aggressive cancer and these patient populations were not considered as well,” Friedewald said. “It was more of a one-size-fits-all approach before. So we definitely applaud the fact that they are recognizing some sub groups of patients who really do need to be screened earlier.”
But there is no recommendation for women with dense breasts, as the USPSTF simply says more study is needed. The Society for Breast Imaging and the American College of Radiology take a more aggressive stance.
“The task force quotes false positives as being one of the greatest risks and it’s not really a false positive,” Friedewald said. “I think that is misleading because we’re not telling patients they have cancer when they don’t. We are merely calling them back from a screening mammogram to do additional testing to see if there’s something that we need to address. So yes, that creates anxiety and that’s stressful for patients and I don’t want minimize that. But the risks of not screening can potentially be death. …If you want to give yourself the best chance of surviving breast cancer, you need to get screened. The most lives are saved if we start screening at 40 every year.”
Currently the World Health Organization recognizes breast cancer as the most common cancer worldwide. But deaths are down in the U.S. by 40-percent since screening began. Doctors believe even more lives will be saved with earlier, annual screening.