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Mammography: Still the Gold Standard continued...

This recent reaffirmation of mammograms has yielded the following guidelines:

  • American Cancer Society and the Dana-Farber Cancer Institute recommend that all women get a mammogram every year beginning at age 40.
  • The National Cancer Institute advocates screening every one to two years for women 40 years and older. Women with higher than average risk of getting breast cancer are also encouraged to ask their doctors if they should start screening at an earlier age, and how often they should have it done.
  • The US Preventive Services Task Force advises women 40 and older to get a mammogram, with or without a breast examination performed by a doctor, every one to two years.

There is an 85% chance that a mammogram will find breast cancer, says Saslow, noting the percentage is significant, even if it's not 100%. A perfect test, she remarks, is not realistic at this time.

Most medical professionals stand by mammography, even with the hazards that come with using it. The device can wrongly highlight something as malignant when it is not. And it can fail to detect a true cancer. But its success rate outweighs those drawbacks, experts say.

"There are risks to most screening methods," reminds Helen Meissner, PhD, chief of National Cancer Institute's Applied Cancer Screening Research Branch.

New Policy on Breast Self Exams

The risks to inspecting your own breasts are similar to the hazards of the mammogram, in that you can miss a true cancer, or mistakenly pinpoint something as a concern. However, doctors have still advised female patients to perform a breast self exam every month.

Leading health groups used to give a strong recommendation for such monthly tests, but after reviewing the studies on screening, they determined there isn't enough evidence to advocate or reject the method.

"The recommendation (for the breast self exam) was never based on evidence," says Saslow, because there is not enough available data on the value of the technique. "It's enough to show that any effectiveness would be extremely small."

Therefore, the US Preventive Services Task Force recommends neither for nor against teaching or performing routine breast self examination. The National Cancer Institute has adopted the same policy.

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