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    Mammogram Guidelines: FAQ

    Q. What kind of harm could there be?

    “False-positives” and overdiagnosis are the biggest concerns. False-positives mean that a mammogram shows something suspicious that later turns out to be nothing. Those can happen at any age, but they're more common in younger women. Before menopause (which usually happens around age 50), women tend to have dense breasts, which can make mammograms harder to read. Getting called back for another mammogram or a biopsy can be stressful. In one survey, 40% of women who had this happen described it as "very scary" or "the scariest time of my life."

    Earlier testing also means more cancers will be found. That sounds like a good thing -- you'd want to catch it, right? But some cancers grow so slowly that they're unlikely to make you sick or even shorten your life span. The problem is that doctors don't always know which ones will cause trouble and which won’t. So some women may get surgery, radiation, and chemotherapy that they don't really need because doctors want to be cautious.

    Q. What are the upsides to starting mammograms at 40?

    Simply put, you're less likely to die of breast cancer, says Bevers, who chairs the National Comprehensive Cancer Network's Breast Cancer Screening and Diagnosis Guideline Panel. That's why she, and many other doctors, still urge women to start at 40 and get checked annually.

    Dennis Citrin, MB, PhD, a cancer doctor at Cancer Treatment Centers of America at Midwestern Regional Medical Center, thinks that women should get their first mammogram at 40 to use as a comparison for future ones.

    Q. How can I weigh the pros and cons?

    Your doctor can help, but you may want to ask yourself these questions:

    How would I feel if I got a false-positive? In one survey, more than one-third of women said they'd be willing to deal with more than 10,000 false-positive mammograms for every breast cancer death avoided.

    How would I feel if I ended up with cancer treatment I didn't really need? One study found that as many as 10 women might be getting overdiagnosed for one death avoided.

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