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FAQ: The American Cancer Society's new mammogram guidelines



Army Medicine via Flickr Creative Commons

The debate over when women should start getting mammograms and how often they should get them took another turn Tuesday when the American Cancer Society updated its guidelines in an article in the Journal of the American Medical Association.

The organization pushed back its suggested age that women be screened for breast cancer and made changes to how often it recommends they be tested. 

So what are the new recommendations?

The American Cancer Society now recommends:

Why did the Cancer Society change its guidelines?

How does this affect the screening debate?

The Cancer Society's new recommendation that annual screening begin at 45 brings it closer to the guidelines of the U.S. Preventive Services Task Force, which published a draft update of its 2009 recommendations earlier this year. The Task Force, a U.S. government-backed independent panel of experts, recommends:

What do other groups say?

Who is considered at "high risk?"

According to the National Institutes of Health's National Cancer Institute, about 1 in 8 women will develop cancer in their lifetime. That also means 7 out of 8 won't. Risk rises with age; there are other factors that increase risk, including:

Here's a handy tool to determine your risk. Note that it's  developed for doctors, but you can print out your results and discuss them with your health care provider.

So what's the bottom line for women?

"The differences [in] recommendations represent different ideas about balancing the benefits and the potential harms of screening," Dr. Jill Jin writes on the JAMA Patient Page.

Most importantly, every organization that has weighed in on this issue stresses that the ultimate decision must rest with each woman, in consultation with her health care provider.

Here's how the Cancer Society puts it:

"Women should be encouraged to be aware of and to discuss their family history and medical history with a clinician, who should periodically ascertain whether a woman's risk factor profile has changed...The intention of this new guideline is to provide both guidance and flexibility for women about when to start and stop screening mammography and how frequently to be screened for breast cancer."

Mammograms: The basics

Mammograms are used to screen for breast cancer. The goal is to catch cancer early: Early-stage cancers are easier to treat than later-stage cancers, and the chance of survival is higher.

The test is potentially life saving, but it also has its drawbacks: