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Answers to your mammogram questions

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Women are confused about mammogram screening, and they have every right to be.

Recently, a government task force turned mammogram guidelines upside down by recommending that most women should not be screened until age 50. And after that, under normal circumstances, they only need a screening mammogram every two years.

This is in direct opposition to what physicians have advised patients to do for 20 years. Which is: Most women, without a family history of breast cancer, need to start mammographic examinations at age 40, and then a screening mammogram every year thereafter.

To set the record straight about mammogram screening and breast self-exam, two experienced Virtua physicians answer the difficult questions women are now asking on this subject.

Here’s what Eric Miller, MD, Virtua breast surgeon, and Larry Rosen, MD, Virtua OB/GYN, say:

What should a woman do about getting a mammogram if she is about to turn 40?

Dr. Miller: The best thing for any woman to do is speak with her physician. Together, they can consider the many factors that go into this decision. It’s important for women to remember that the new government task force guidelines are only guidelines – not hard and fast rules. And, this is only one recommendation. For my own practice and family, I still advise women to follow traditional mammogram screening guidelines.

Is breast cancer a common disease in women between age 40 and 50?

Dr. Rosen: Breast cancer is less common in women within this age group, but it does and can occur. And, when breast cancer occurs in a younger woman, it can be a more aggressive disease. Women need to start screening at age 40, and then yearly from age 40 on. Over the years, I have seen many breast cancers identified on a mammogram in women who are in their early 40s. If these same women had waited until they were 50 to get their first screening, who knows how well they might have done in fighting the disease.

What about breast self-exams? Are they still important?

Dr. Miller: In my opinion, they are. Women simply need to be informed about the data. If, during a breast self-exam, someone finds a suspicious lump or thickening, many times, it can be observed. If a biopsy is needed, it can often be performed in the doctor’s office. In addition, 80 percent of the lumps biopsied are benign. For the remaining 20 percent that are malignant, they are then identified as early as possible.

Any closing thoughts on mammogram recommendations?

Dr. Rosen: Women are not statistics. I base my clinical practice on more than 20 years of working with women and helping them stay as healthy as possible.

Dr. Miller: The major medical organizations in this country — the American Cancer Society, the American College of Surgeons, and the American College of Obstetricians and Gynecologists to name just a few — all recommend annual screening mammogram from age 40 on. It is still the best way we have to identify early stage breast cancer.