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    Mammogram Guidelines: FAQ

    By Barbara Brody
    WebMD Feature
    Reviewed by Nivin Todd, MD

    If you're approaching the big 4-0, you're probably wondering if it's time to book your first mammogram -- or if you can put it off for another few years. It's no wonder you're confused: Conflicting guidelines from leading medical groups have made this issue murkier than ever. Some key facts can help you decide.

    Q. When do health experts say you should start getting mammograms?

    The main expert you need to check with is your doctor. He will consider your particular case, including your age, family, and other things that make you likely to need mammograms sooner rather than later.

    As for medical groups, there are many, and they don't agree on this issue.

    For years, the American Cancer Society (ACS) urged women to start mammograms at age 40, but they recently changed their guidelines. They now recommend beginning them at age 45, or at 40 if the patient chooses.

    Other groups, such as the American College of Obstetricians and Gynecologists (ACOG), say that starting at 40 is best. Meanwhile, the U.S. Preventive Services Task Force Services (USPSTF) says that women can wait until 50.

    There's also the related issue of how often to get tested. ACOG says go annually. USPSTF says every 2 years. The most recent ACS guidelines suggest getting annual mammograms between ages 45 and 54; after that, they say it's OK to wait 2 years between screenings.

    Q. So which group is right?

    It's less a question of who's right and wrong and more about how various people interpret the data and which studies they pay most attention to. Experts in each of these groups have reviewed the evidence in favor of starting earlier vs. later and come to different conclusions.

    "Nobody is arguing that fewer women won't die if they get mammograms at 40, and nobody is arguing there aren't harms that come along with starting that early," says Therese Bevers, MD, medical director of the Cancer Prevention Center at the University of Texas M.D. Anderson Cancer Center. She explains that groups pushing for later testing are simply giving more weight to the downsides.

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