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New Breast Cancer Screening Guidelines

Yearly Mammograms for 40+, but no More Monthly Self-Exams
WebMD Health News

May 14, 2003 -- New guidelines announced today by the American Cancer Society should help clear up confusion about breast cancer screening. The recommendations call for yearly screening mammograms for all healthy women starting at age 40, but put less emphasis on monthly breast self-examinations than in the past.

The guidelines no longer call for women to perform monthly breast self-exams, because there is no evidence the practice saves lives. A better approach for most women is to become familiar with their breasts so they will be aware of changes as soon as they occur, an ACS spokeswoman tells WebMD.

"If a woman feels more comfortable doing a monthly exam, that is fine," says Debbie Saslow, PhD, director of breast and gynecologic cancers for the ACS. "We are saying this is an option for women who feel it helps them be more aware of their breasts. But it is no longer something we are asking them to do because the evidence (of its usefulness) just isn't there."

There has been tremendous debate over the benefits of mammograms in preventing breast cancer deaths particularly among women younger than 50 and over 70, and the new breast cancer screening recommendations were written with this in mind. The ACS has recommended annual mammograms for women 40 and over for many years, and Saslow says long-term follow-up studies now offer unequivocal evidence of the value of yearly mammography screening.

She says annual breast cancer screening makes sense for younger women, whose tumors tend to be fast growing. Annual screening also makes sense for older women. Though their cancers often spread more slowly, they occur far more frequently. Roughly 75% of all breast cancers are diagnosed in women over 50.

"We are more confident than ever that mammograms are useful in women 40 to 49, and in older women," Saslow says. "The reason for screening is to be able to detect a tumor in time to do something about it. If you wait two years between mammograms you increase the chances that screening won't make a difference."

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