Annual Mammography Screening Should Begin at 40

Mammography, clinical, and self breast examination are recommended for breast cancer screening

THURSDAY, July 21 (HealthDay News) -- Annual mammography screening for breast cancer in women should begin at age 40 years, and not at age 50 as previously recommended, according to the American College of Obstetricians and Gynecologists' (ACOG's) Practice Bulletin on Breast Cancer Screening, published in the August issue of Obstetrics & Gynecology.

Jennifer Griffin, M.D., M.P.H., from the Committee on Practice Bulletins -- Gynecology, ACOG, in Washington, D.C., and colleagues reviewed available literature from 1990 to 2011, to formulate new breast cancer screening guidelines. They also searched for evidence to support and grade their recommendations.

The authors reported that, although breast cancer is the most commonly diagnosed noncutaneous cancer, and the second leading cause of cancer death in American women, earlier detection and improved treatment have contributed to a steady decrease in breast cancer-related mortality since 1990. ACOG continues to recommend three methods of screening: mammography, clinical breast examination (CBE), and breast self-examination (BSE). The new mammography screening guidelines recommend annual mammography for women beginning at age 40 (instead of age 50 years). ACOG continues to recommend CBE annually for women aged 40 and older, and every one to three years for women aged 20 to 39 years. BSE and education on breast self-awareness is recommended for women aged 20 and older. Women should be educated about the predictive value of mammography. Enhanced breast cancer screening is recommended for women with estimated lifetime breast cancer risk of 20 percent or more, or for women with positive BRCA1 and BRCA2 mutations. Breast MRI screening is not recommended for women at average breast cancer risk.

"If women in their 40s have annual mammograms, there is a better chance of detecting and treating the cancer before it has time to spread than if they wait two years between mammograms," the authors write.

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