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New Mammogram Screening Guidelines FAQ

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WebMD Feature
Reviewed by Louise Chang, MD

The U.S. Preventive Services Task Force (USPSTF) is recommending sweeping changes in its breast cancer screening guidelines.

The USPSTF, which is a group of independent health experts convened by the Department of Health and Human Services, reviewed and commissioned research to develop computer-simulated models comparing the expected outcomes under different screening scenarios.

Here are the USPSTF's recommendations, based on all that work:

  • Routine screening of average-risk women should begin at age 50, instead of age 40.
  • Routine screening should end at age 74.
  • Women should get screening mammograms every two years instead of every year.
  • Breast self-exams have little value, based on findings from several large studies.

But the new recommendations may leave some women confused, since the American Cancer Society continues to recommend annual mammography screening for all healthy women beginning at age 40. What's the bottom line on mammogram screening? WebMD asked breast cancer experts about the new USPSTF screening guidelines.

If a woman younger than 50 or older than 74 wants to get a screening mammogram, can she?

The guidelines don't ban anyone from getting a screening mammogram. But it's not yet known if the new guidelines will affect mammography coverage by insurance companies and other providers.

Task force vice-chair Diana B. Petitti, MD, tells WebMD the new guidelines don't apply to women with risk factors for breast cancer, such as BRCA mutations or a close family history of the disease.

She adds that they also do not mean average-risk women who are younger than 50 or older than 74 should never be screened.

"This is not telling [average-risk] women in these age groups they can't get screened," Petitti says. "A woman who still wants to be screened after having the conversation with her clinician and considering the balance of benefits and harms should absolutely be screened."

Will insurance pay for a mammogram if I'm younger than 50 or older than 74?

As for paying for those mammograms, the USPSTF recommendations are influential in guiding policy, but the group doesn't make specific recommendations about reimbursement.

It remains to be seen if the sweeping health care bill now being considered by Congress will reflect the new recommendations.

American Cancer Society national volunteer president Elizabeth T.H. Fontham, MD, says there is a good chance that Medicare and private insurers will stop paying for annual mammogram screenings and screening for women in their 40s and over 74.

"Ultimately, this could increase economic disparities associated with breast cancer screening," Fontham says. "Women who want to be screened and can pay for it can still get screened. But those who can't pay may be out of luck."

What if I find a lump and I'm younger than 50 or older than 74?

The new guidelines are just about routine screening mammograms. They're not about getting a mammogram when you have a lump or other suspicious finding or if you're at high risk of breast cancer.

Any woman, of any age, should get a suspicious lump or other breast change checked out.

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