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New breast cancer guidelines push recommended screening age

Women at average risk for breast cancer should start regular annual screening using mammography at age 45 and transition to screening every two years starting at age 55, according to new guidelines from the American Cancer Society, published Oct. 20 in the Journal of the American Medical Association.

That’s a change from the old guideline that recommended screening start at age 40 and that exams continue on an annual basis for older women. Based on an evidence review, the American Cancer Society Guideline Development Group concluded there is a benefit from screening with mammography for women in their early 40s, according to a news release, but that risk is lower and harms, primarily from false positives, are somewhat greater for women ages 40-44 than for women in older age groups.

Cancers grow more slowly in post-menopausal women and biennial screening will give women 55 and older most of the benefit, with less risk, the development group review found.

Balancing benefits and harm

However, the guidelines recommend women ages 40-44 should have the option to begin screening early, and women 55 and older should have the opportunity to continue annual screens if they choose, according to the release. “These recommendations are made with the intent of maximizing reductions in breast cancer mortality and years of life saved while being attentive to the need to minimize harms associated with screening,” Kevin Oeffinger, MD, chairman of the breast cancer guideline panel and a family physician at Memorial Sloan Kettering Cancer Center, said in a news release. “The benefits, burdens and judgment about that balance differ depending on a woman’s age, health, values and preferences. These recommendations recognize and reflect those differences.”

The guideline recommends all women should become familiar with the potential benefits, limitations, and harms associated with breast cancer screening. It gives a strong recommendation that women with an average risk of breast cancer should undergo regular screening mammography starting at age 45.

It also gives qualified recommendations that women ages 45-54 should be screened annually; women 55 and older should transition to biennial screening but have the opportunity to continue screening annually; and that women 40-44 should have the opportunity to begin annual screening between the ages of 40 and 44.

Qualified recommendations indicate there is clear evidence of benefit of screening but less certainty about the balance of benefits and harms, or about patients’ values and preferences. “This guideline relies on the best evidence to offer new, more precise guidance taking into account a woman’s age, health and personal values and preferences,” Elizabeth Fontham, founding dean of the School of Public Health at LSU Health Sciences Center in New Orleans and chairwoman of the ACS Guideline Development Group, said in the release. “Though the evidence shows that there are some benefits from mammography screening starting at age 40, those benefits more clearly outweigh the harms from age 45 onward. Still, some women will choose to begin screening between age 40 and 44, both because they are concerned about their risk of breast cancer, either in general or because they are at higher risk, and are less concerned about the chances of experiencing a false positive findings.  hose women should have the opportunity to start screening at 40 if they choose.”

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By | 2015-10-22T18:35:31-04:00 October 22nd, 2015|Categories: Nursing news, Nursing specialties|4 Comments

About the Author:

Sallie Jimenez
Sallie Jimenez is content manager for healthcare for Nurse.com published by Relias. She develops and edits content for the Nurse.com blog, which covers industry news and trends in the nursing profession and healthcare. She also develops content for the Nurse.com Digital Editions. She has more than 24 years of healthcare journalism, content marketing and editing experience.

4 Comments

  1. Avatar
    Karen Johnson November 2, 2015 at 3:29 pm - Reply

    I am concerned about changing the ages for mammography. There is a history of Breast cancer in my family. I had a lumpectomy in my twenties and two biopsies since that time. All were benign thank God. I never fail to have my mammogram and will continue to do so regardless of the changes. Mammography identifies things we are not always able to feel especially if we are large breasted. My mother had breast cancer at 70 and if not for the mamogram she would not have known. A woman can be at risk at any age. If the recommendations change so will the preventative medicine part of insurance and without that a lot of women will be forced to follow the new recommendations. I fear there will be an increase in the number of cases and because things are not cuaght at an earlier time the mortality rate will also increase.

    • Avatar
      Sharon November 3, 2015 at 5:40 pm - Reply

      I am sure these changes are from pressure by the AFA. Trying to save money by shortchanging women. I think it’s overkill to call a false positive “harm”. Not finding it on time is real harm. I smell a dead fish!

    • Avatar
      C. Klepser November 5, 2015 at 5:10 pm - Reply

      I appreciate your point, but these recommendations are for women “with average risk” for breast cancer. With a family history, you have increased risk. I just hope insurance companies take a person’s risk level into account!

  2. Avatar
    Sherry Grannan November 9, 2015 at 4:50 am - Reply

    My mother passed away at the age of 43. She had bilateral metastatic breast cancer. My doctor started mammograms me at the age of 25. I have had one done yearly, and I am now 65.
    So far I’m clear, and hope that medicare will cover this yearly test for me. If not I’ll cover the cost of it myself.

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