New guidelines urge women to screen earlier for breast cancer
Texas State Health Services says breast cancer is the second most common cause of cancer death among women in Texas.
The U.S. Preventable Services Task Force now urges women to begin screening every two years for the disease, beginning at 40 instead of 50, to help save lives.
Dr. Cynara Coomer, a breast surgeon with Texas Health Breast Specialists, agrees with earlier screening, but she told KERA’s Sam Baker mammograms should happen annually.
The reason for the annual mammograms is that although, yes, the incidence of breast cancer in women in their forties is lower than in women in their fifties, and even more so in their sixties, the reality is that those breast cancers tend to be more aggressive than postmenopausal female breast cancers.
And so the goal would be to identify those cancers as early as possible because they do tend to grow and spread a little bit more aggressively.
So why would the task force stick with every two years?
The reason for wanting to do it every two years is that women in their forties are more likely to be either overdiagnosed, or have a higher risk of having false positives. The other argument is the potential risk of overtreatment.
And although, yes, we are potentially risking that, for the number of lives that breast cancer treatments have saved over the years, better safe than sorry.
Black women are said to be 40% more likely to die from breast cancer. So would they benefit from earlier screenings?
Not necessarily from earlier screenings.
Unless they have a family history of breast cancer or are deemed to be of higher risk based on individual factors, the general rule of thumb is to start at the age of 40 to have annual mammograms.
But they do tend to have more aggressive types of breast cancers, and they also tend to be diagnosed at a later stage for various different reasons. So for that reason, they do have a higher incidence of mortality with breast cancer compared to non-Hispanic whites.
We hope that this does not dissuade women from going from annual mammograms and that it encourages them to start mammogram screening at the age of 40. But we certainly would prefer annual screening because of the fact that some women are more prone to developing more aggressive types of breast cancers.
So, in terms of the population overall, do these new recommendations improve matters?
I think most patients who are seeking regular health care from primary care doctors or their gynecologists generally would have been recommended to have screened at the age of 40.
So hopefully for those who may not have been following the American College of Radiology guidelines or the NCC guidelines, hopefully this will, you know, help them to educate them in regards to starting at the age of 40.
But we certainly don't want to discourage women from doing annual screenings. You know, obviously, talk about it with your doctor. Some women should be starting earlier than the age of 40, if they're found to be high risk.
Who is considered at high risk for breast cancer?
If you have a family history of breast cancer, especially a first-degree relative, that's going that could potentially double your risk for developing breast cancer.
Certainly, if women choose to have to choose to get pregnant at a later age, that may also increase their risk.
If you have a known family history of genetic mutation in the family, that increases your risk for breast cancer.
These are discussions to have with your physician or certainly when you go in for a screening mammogram, because if you are identified as a high-risk patient, then your screening will change.
It'll either be more frequent, there may be the addition of MRI's, or you may need to start at an earlier age if your family members were diagnosed with breast cancer prior to the age of 50.