Is it time to get your first or next mammogram? The question can be tricky.
The American Cancer Society says women should get mammograms every year starting at age 45. The U.S. Preventive Services Task Force says you can hold off till you're 50 and that you need the test only every other year, while the American Congress of Obstetricians and Gynecologists recommend yearly screening mammograms beginning at age 40
So how do you decide?
Women who have a higher breast cancer risk could benefit from getting these screening tests sooner. "Others have a greater risk of harm from earlier mammograms," says Karla Kerlikowske, MD, a primary care doctor who researches breast cancer risk at the University of California, San Francisco.
Talk with your doctor to decide what's best for you, and consider these questions:
What's age got to do with it? A woman's average risk of getting breast cancer over the next 10 years increases with age. A 40-year-old woman has less than a 2% chance. In a group of 100 women who are 40 years old, fewer than two of them will get the disease in the next 10 years. About 20% of 40-year-olds have a higher risk," Kerlikowske says. For women with no other risk factors, she doesn't recommend mammograms before age 50.
At 50, women's risk is just over 2%. At 60, it's 3.5%. Breast cancer isn't very common for women between 50 and 59, Kerlikowske says, but when mammograms do find breast cancer, they can help lower the chance of death. "The women that absolutely benefit most," she says, "are between 60 and 69. With them, I push a little more." Almost 4 in 100 women who are 60 years old will get breast cancer in the next 10 years.
What about other risk factors? Your ethnicity figures into your chances of getting the disease. Non-Hispanic white women have the highest breast cancer rates, then African-Americans, followed by Latinas, Native Americans, and Asian women.
If you've had breast cancer before, your continued risk is above average. If your mother, sister, or daughter has had breast cancer, your chances are higher.
The disease is more likely to develop in dense breasts, which contain more connective and non-fatty tissue compared with non-dense breasts. A mammogram is the only way to know your breast density.
What risks come with screening? Every mammogram brings the chance of a result that incorrectly says you have the disease, which could lead to further tests, unnecessary radiation, and unnecessary treatment. If you get a mammogram every year for 10 years, you have a 50% chance of getting this "false positive" result at some point during those 10 years. Some women who get false positives end up having breast biopsies. But only 1 in 4 biopsies turns out to be cancerous.
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