Breast cancer is the most common form of cancer in women worldwide, and it is estimated that more than 40,000 women in the United States will die of breast cancer in 2015. Early detection can help improve survival rate. The American Cancer Society (ACS) previously recommended women be screened each year from the age of 40 years. However, this leading US medical association has changed its advice because evidence failed to show enough lives are being saved.
The ACS has now urged women to wait until the age of 45 years before getting an annual mammogram to screen for breast cancer. While younger women are being advised to start later, women over 55 years are now urged to switch to getting mammograms every two years, instead of annually. The researchers observed that screening all women before the age of 40 years can also lead to problems, such as false positives, biopsies, surgeries to remove masses that may not have been dangerous, and potential surgical complications.
The researchers suggested that offering more sophisticated screening tests, including genomic risk factors, would be better for younger women than expanded screening mammography.
The new ACS guidelines also no longer recommend breast examinations, in which clinicians manually feel patients' breasts for lumps, for women of any age who do not have a family history of breast cancer. The guidelines noted, "Women should still have the opportunity to begin annual screenings at 40 years if they choose."
These updated guidelines are now closer in line with the other major issuer of health guidelines. The US Preventive Services Task Force has already said, "There is not enough evidence to support clinical breast exams as a way of finding breast cancer or preventing breast cancer deaths." Both medical groups also recommend that screening decisions be individualized to reflect a woman's preferences and her underlying risk of breast cancer.
The ACS guidelines are published in the Journal of the American Medical Association (JAMA)