New mammogram guidelines released Monday by a national group of physicians recommend women of "average risk" wait longer to get their first mammogram, but a top doctor in Chicago disagrees.
Citing the tests' false positives and ensuing increased anxiety, the American College of Physicians suggest that women without a family history of breast cancer can wait until age 50 to get a mammogram and then get the screening every other year.
"Breast cancer screening, like all tests, has both benefits and harms," said ACP President Dr. Ana María López, "so it's important for women to, No. 1, be informed. Know the facts. And also, consider your own personal values, your own personal preferences, to make the decision that is right for you."
Waiting until 50 is a departure from other recommendations. The American Cancer Society, for example, recommends women start getting mammograms at age 45.
Dr. Sarah Friedewald, Northwestern Medicine's chief of breast imaging, vehemently disagrees with the ACP's guidance and said the guidelines have made her "frustrated, primarily, and surprised."
"What’s frustrating for us is these guidelines further muddy the waters and likely will have an effect on patients not getting screened when they should be," Dr. Friedewald said.
Dr. Friedewald believes even 45 is too late.
"What we recommend is annual screening every year beginning at age 40," she said, adding, "Everyone agrees the most lives are saved if you screen every year beginning at age 40, and we believe that is the most important recommendation."
Dr. López said women with average risk and no symptoms should begin having a conversation with their doctors "about the benefits, the harms of breast cancer screening."
"It's important to remember that this ACP guidance statement does not apply to women who are at higher risk, who have had a prior abnormal study, who may have had a personal history of breast cancer, or who may have a genetic mutation that places them at higher risk for breast cancer," Dr. López said.
Breast experts said they are concerned the varying guidelines could impact insurance coverage and confuse patients.
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"By delaying screening until 50, you are actually disadvantigng some of our patient populations," Dr. Friedewald said. "Our goal is to save as many lives as possible."
Even though the age guidelines vary, one recommendation is consistent: Talk to your doctor if you have any concerns.
