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New Mammogram Screening Guidelines FAQ

The new guidelines recommend against breast self-exams and question the benefits of clinical breast exams performed by health care providers. Why?

Two major studies, one from China and another from Russia, found no evidence that breast self-examinations reduced deaths from breast cancer, but that the practice leads to additional screening and biopsies.

"The self-exam data were pretty definitive," Pettiti says. "There is high certainty that there is no benefit, and there are harms which include unnecessary anxiety from finding something that isn't cancer."

But that doesn't mean a woman should ever ignore a suspicious lump.

"That definitely is not the message," Petitti says. "Anything unusual should be checked out."

The USPSTF panel concluded the current evidence is insufficient to assess the risks and benefits of clinical breast exams performed by health care providers.

Evers says she will continue to recommend breast self-exams.

"I don't think the practice is useless," she says. "For many women it is important because it helps them feel somewhat empowered and in control of their own breast health."

What should average-risk women in their 40s be doing if mammography and self-exams are no longer recommended?

Although the experts interviewed for this story had different opinions about whether routine screening is advisable, they all agree that any woman concerned about breast cancer should discuss her own situation with her doctor or other health care provider.

The new guidelines don't apply to women at high risk for breast cancer. How often should these women get screened?

The new guidelines aren't about women at high risk of breast cancer.

The American Cancer Society defines high-risk as women with a greater than 20% lifetime risk of breast cancer. This includes women with BRCA1 and BRCA2 gene mutations and women who have not been tested but have a parent, sibling, or child with a BRCA mutation, as well as certain other groups of women.

The ACS recommends that high-risk women have annual mammograms along with an MRI beginning at age 30 and continuing for as long as they are in good health.

Women with a 15% to 20% lifetime risk for breast cancer are considered to have a moderately increased risk for the disease.

ACS recommends that these women talk to their doctors about the benefits and risks of adding MRI to annual mammogram screening.

If a woman's breast cancer risk increases with age, why stop screening at 74?

Very few breast cancer screening studies include women in their mid-70s and older. The task force noted that "breast cancer is a leading cause of death in older women, which might suggest that the benefits of screening could be important at this age."

However, the USPSTF also concluded that the benefits of screening are probably not as great for older women because they tend to have breast cancers that respond well to treatment and have a higher risk of dying from other causes.

The panel noted that the risk of overdiagnosis and unnecessary treatment is greater in elderly women than in younger ones because of their increased risk for death from other causes.

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