Ob-Gyn Group Recommends Annual Mammograms in 40s
American College of Obstetricians and Gynecologists Issues Guidelines on Breast Cancer Screening
Age Factor in Breast Cancer Detection
The time interval from when a breast cancer is detectable with mammography to when the cancer grows big enough to cause symptoms is referred to as the sojourn time.
Age is the biggest predictor of sojourn time, with women in their 40s having the shortest average interval of two to 2.4 years, compared to around four years for women in their early 70s.
This means that the window to detect tumors while they are still highly treatable is much shorter for younger women.
In general, women with breast cancers detected at their earliest stage have a 98% survival rate. Survival drops to around 75% for patient with stage II disease and to just 15% for those with stage IV disease, according to the American Cancer Society.
ACOG continues to recommend that women 40 and older with an average risk of breast cancer have annual manual breast exams performed by a doctor. Manual exams are recommended every one to three years for women between the ages of 20 and 39.
The group no longer recommends routine monthly breast self-exams, which were not very effective. Instead, ACOG is promoting breast self-awareness -- the idea that when women understand the normal appearance and feel of their breasts they can recognize suspicious changes more quickly.
Lauren Cassell, MD, who is chief of breast surgery at New York's Lenox Hill Hospital, applauds ACOG's move to simplify the mammography screening message to women in their 40s.
"There has been a lot of confusion since the USPSTF guidelines came out," she tells WebMD. "I've had [younger] patients ask me if they can still get screened."
While she understands the arguments against screening women in their 40s every year, Cassell says the benefits of mammogram screening are obvious to doctors like her who treat breast cancer patients every day.
"We see plenty of patients in their 40s whose cancers were found solely through mammography," she says. "I understand that for many women screening is stressful. But I'm not willing to throw younger women with breast cancer under the bus because some women will be stressed out."