Breast cancer screening guidelines are set to change to now recommend yearly mammograms beginning at age 40 instead of 50. The U.S. Preventive Services Task Force has released new draft guidelines, which will likely become official in a few months. The screening recommendations are not only different from the Task Force’s previous recommendation, but from those of American College of Obstetricians and Gynecologists and the American Cancer Society. Basically, all these organizations are saying something different, but the Task Force says their change to age 40 could result in 19% more lives being saved.
The U.S. Preventive Services Task Force just released new draft guidelines on breast cancer prevention, and they’re stirring up some questions. The panel of medical experts now recommends that women start having regular mammograms at age 40 — a huge departure from previous guidance, which said that women should start mammograms by age 50.
This is a draft recommendation — in other words, it’s not final yet — but it’s expected to become official in a few months.
According to the new draft guidelines, women should be screened for breast cancer every other year starting at age 40 to lower their risk of dying from the disease. “While the Task Force has consistently recognized the lifesaving value of mammography, we previously recommended that women in their 40s make an individual decision about when to start screening based on their health history and preferences,” a statement from the Task Force says. “In this new recommendation, the Task Force now recommends that all women get screened starting at age 40. This change could result in 19% more lives being saved.”
But the screening recommendations are different from those of other organizations, including the American College of Obstetricians and Gynecologists and the American Cancer Society — which are also different from each other. What’s going on here, and why are breast cancer prevention guidelines so confusing? Doctors break it all down.
What led to the new mammography screening recommendations?
It’s important to point out that the screening recommendations revert to what the Task Force used to recommend around mammograms. In 2009, the organization increased the recommended age for routine mammograms from 40 to 50. At the time, the panel expressed concerns that starting screening at age 40 could lead to unnecessary treatments, such as unneeded biopsies and other therapies over false positives for cancer.
But since then, breast cancer diagnoses have increased — especially in women under 50 and younger Black women, who are dying from breast cancer at nearly double the rate of white women of the same age.
But many doctors say they’ve been recommending that women get screened for breast cancer starting at age 40, regardless of what the Task Force said in the past. “That has been our practice despite the earlier guidelines,” Dr. Parvin Peddi, a medical oncologist and director of breast medical oncology for the Margie Petersen Breast Center at Providence Saint John’s Health Center, tells Yahoo Life. “There are still many patients diagnosed prior to 50.”
Edmonds and Dr. Therese Bevers, medical director of the Cancer Prevention Center at MD Anderson Cancer Center, also tell Yahoo Life that their medical centers recommend annual screenings for average-risk women.
How often should people be screened who are average risk vs. higher risk?
The Task Force guidelines say that all women should start regular mammograms at age 40, but women who are considered high risk may need to start screening even earlier.
“Women at higher risk of breast cancer should also be screened annually,” Edmonds says. “The age of screening onset depends on their specific risk factors and level of risk and should be determined by a breast cancer specialist. Those who are at greater than or equal to 20% lifetime risk of breast cancer should be screened with annual breast MRI.” (Factors such as your family and personal history can weigh into your risk for breast cancer.)
What does this all mean for insurance?
The Task Force recommendations usually guide insurance coverage of screening tests, Bevers says. “Thus, a recommendation to begin screening mammography at age 40 protects insurance coverage for women age 40 and above,” Edmonds says.
I think that stat — with potentially 19% more lives being saved — is pretty important. Apparently the Task Force used to recommend age 40, switched to age 50, but is now reverting back to age 40 because in the past 14 years since it was changed breast cancer diagnoses have increased in women under 50 and younger Black women. So the present day statistics warrant the earlier screenings. I haven’t had a mammogram yet, but getting your boobs smushed in a machine annually seems like a minor inconvenience compared to the alternative. The Task Force also says higher risk women should start screening annually earlier than at age 40. And the Task Force recommendation to start screening at age 40 will influence insurance, including mammogram coverage for women at age 40 and above.
My mammogram was seriously uncomfortable, but they spotted something. Luckily benign, but serious discomfort is absolutely worth it.
My life was extremely stressful last year and I didn’t get a mammogram. I got one a few months ago that resulted in a biopsy and an upcoming excision. Maybe that would have happened a year earlier, maybe not, but I learned a tough lesson.
Don’t beat yourself up over the maybes & could haves & should haves. And take care, wishing for the best.
Thanks, Beanie ❤
I’ve been getting mine annually since turning 40 6 years ago. I’m only a 3% lifetime risk compared to the average 12%, yet they’ve still had me doing annual since 40.
Had my yearly mammogram yesterday.
It is…. awkward, and minorly uncomfortable. Weird lean in, awkward stance, super squished boob between pieces of plexiglass- and being a bit manhandled (by a a woman technician).
But it is actually over pretty quickly.
And it could save your life.
Don’t put it off please.
And some technicians are better than others. I’ve been having them annually since 40 because that was the recommendation for those of us considered high risk (my mom died of breast cancer); my small, dense breasts are apparently a challenge to work with! But truly it’s no big deal, takes not much time, and it’s better to catch something early.
My first mammogram was a nightmare, squished my breasts as flat as it could and was very pinchy, upsetting physically and emotionally. That was years ago and they have much better machines which produce better images! I don’t mind going at all.
I thought it was always 40. My OB/GYN told me that when I turned 40 and wrote me an order for a mammogram. Ive gotten one every year since. I’m surprised to learn this wasn’t always standard. They are nerve wracking for sure but I am adamant about making sure to have one. I didn’t find mine that uncomfortable. I do know that can depend on breast size, tissue density, etc.
I put off getting a mammogram for years because I was afraid of the pain. When I finally went, the technician said that the procedure is not supposed to hurt at all and that it would be easier than I thought. Aside from the awkward positions, it did not hurt at all and was easier than I thought. So, I don’t know if other techs are not being trained to minimize the discomfort or what.
I fortunately started earlier due to family history. I have breast cancer and they did a lumpectomy. Did chemo. Have her2. Am taking a pill for the next 3 years. Hair has grown back. Feeling great. I’m happy they start the screening earlier. Technology has come a long way! It can spot very tiny stuff. DONT PUT IT OFF!!
Tamoxifen is keeping my HR+ Tuma Thurman from returning, so high five, fellow survivor!
Cait. Am on anastozole for three years. Did the chemo and another drug through my port . Twelve weeks chemo and a year of the other once a week. Was lucky I found it quickly. Congratulations to you too!!!
Hah, another Tamoxifen patient here. 🙂
Starting tamoxifen now. I am a little scared? I feel silly saying that but would love to hear some experiences if anyone wants to share. It is preventative for me as I was just diagnosed with LCIS thanks to a breast reduction (my mammogram was clean).
Mammograms are not scary. In fact if you get a good tech, you probably won’t even remember it. I just went last year and I was super scared because of stories and my mom always complaining and I swear I was shocked at how easy peasy it went.
I think it’s important not to scare young people so when they have to get it, they won’t have those fear thoughts about it,
like I did.
It’s nothing. Get a mammogram.
I’m confused. Are they recommending annual mammograms for women over 40 or every other year? The article header and the article info has conflicting info.
When you get a mammogram, be sure to find out your breast density. If you have high density, a mammogram may not be as accurate and supplemental screening like an ultrasound will be helpful. I have the highest density so I do a mammogram one year and breast ultrasound the other year.
Mine are dense & I get a 3D every year now, probably for the last five years, I’d say, since the technology became readily available. I had a follow-up ultrasound once. For that one, they told me the lump was just a cyst but because my mother died of breast cancer & I’d read too many articles about women being told ‘it’s just a cyst’ only to find out a year later they have
Stage IV breast cancer, I told my doc I wanted it out, I wanted it biopsied. She said I don’t blame you & referred me to a surgeon. I still remember that, because it was an all-female surgery team that day & we were all remarking on that! And yes, just a cyst, but I had piece of mind to go along with it.
Unfortunately, the new recommendation is every other year, so actually a reduction in the number of mammograms a woman can get over her lifetime.
Thanks for clarifying, @Mrs.Krabapple. Yes, every other year means a reduction in the number of mammograms a woman will get but hopefully lowering the age to 40 means that overall, more women will get mammograms. It would be great if all women 40+ could get one every year. 2 years seems so long as cancer can develop and grow immensely in two years.
I was diagnosed with breast cancer two years ago at 42. Increasingly men and women are dealing with cancer at younger and younger ages.
I’m guessing colonoscopy guidance is also about to change to include younger folks, too.
Yeah one of my close friends was diagnosed at 40 (during covid as an extra bonus) after she found a lump. She’s clear now but having annual screening to keep an eye on things and when she did find another lump (that turned out to be nothing – PHEW) they reacted super fast. But here in the UK we’re definitely not screening from 40. I’m 44 and have been having my regular smear tests as long as I can remember but no word on mammograms.
I am honestly surprised that nobody is mentioning a big issue with mammography, and that is over-diagnosis and over-treatment. I would encourage everybody to watch a film called Pink Ribbons, Inc., which is a critical look at the breast cancer world. In reality, there is not a ton of evidence that mammography improves outcomes, and that is because mammograms are actually lousy at detecting the form of breast cancer most likely to be fatal, which is inflammatory breast cancer (or IBC).
The type of BC most likely to be detected via mammogram is something called ductal carcinoma in situ (DCIS). These are small lumps that tend to form in the milk ducts. But they are generally super-slow growing. A friend of mine was diagnosed with one and was told quite plainly that she’d had to live to 200 in order for it to pose any real threat to her life. In such cases, “leave it be” may be a viable course of action, but very few women are comfortable with that. So we now have an epidemic of women undergoing mastectomies and chemo that they may not need to go through.
Sorry for the rant, but this is something I’ve been involved with for a while and it irritates me to see mammography still being oushed so aggressively when it’s of limited benefit. The real solutions to breast cancer will come from 2 places:
1.) Better environmental laws: there is a growing body of evidence that breast cancer is linked to factors in the environment, such as chemicals in plastics, water, etc. (think of PFAS, BPA, stuff like that). But you and I can’t avoid that stuff. We need stronger laws that will actually result in those things being removed from our homes and products. Why do you think breast cancer is more common in WOC, especially Black women? It’s because they are far more at risk of being exposed to environmental carcinogens over their lifetimes.
2.) Better treatments for the women who will continue to get it, ESPECIALLY the women with IBC who whom mammography did not help. They are the ones still being failed by standards like this. (In this, I also include genetic screenings for BRCA mutations, since women deserve to know their risk).
Just please do not accept guidelines like this as gospel truth.
I was hoping for this side of it to be presented. Thank you.
💯
I apologize in advance, this will be long: Breast cancer has affected me and my mother. I ABSOLUTELY agree that the real issue is having better environmental laws to protect women from getting it in the first place. I cringe when I see car companies, or some other “polluting” corporation, try to gain good will by celebrating the pink ribbon. No, you don’t get any brownie points from me, when you are *contributing* to the problem. I also dislike the narrative that somehow women can “take control” of their lives through mammograms and other screenings, because it’s not about how much will or determination a woman has, and getting cancer is out of her hands — but you would never know that from the pink ribbon people, who only “celebrate” triumph and don’t like to acknowledge those with stage IV who put a damper on the fun.
And sad to say, mammograms are not some type of cancer prevention plan. It does not, in any way, protect you from getting cancer. A mammogram will tell you once you do have cancer, but it won’t prevent it. I have read articles using mammogram in the same category as preventive care, and it is NOT.
Having said all that, I strongly encourage yearly mammograms for all women. Even if they don’t prevent cancer, the earlier you catch cancer, the better. I went for the most radical treatment I could when my lump was found. That’s because my mother’s initial cancer did not kill her, and she was able to survive after lumpectomy and chem/radiation. However, if there are any cancer cells left in your body, they can come back, and now mom has stage IV, which is incurable. It’s better to catch it early and potentially kill as much of the cancer cells in your body before they have a chance to grow. That’s just my own opinion, obviously I’m not a doctor. But the first step in trying to eliminate all cancer cells is the discovery you have cancer in the first place, and to me that means early and yearly mammograms are necessary (and ultrasounds if you have dense breast tissue like I did).
Sorry for the rant! I just feel passionately about this.
Sorry, no. This is like saying “a seat belt doesn’t always save your life.” Breast cancer is much more treatable when caught early, and the best method — still — for early detection is mammography. Until we can control all those environmental factors, early detection DOES increase a woman’s chance of an optimal outcome.
Mammography is not a treatment. There is no “over-treatment” of breast cancer, because mammography is only the first step in the protocol. If something suspicious is found on a mammo, they don’t just start dousing you in chemo. Many, many other steps are taken to verify whether that suspicion is indeed cancer.
Also, WOC unfortunately have shown much lower rates of participation in mammography screening, so stating that their increased cancer mortality is due to increased exposure to carcinogens is not necessarily true. We don’t know exact cause + effect.
Wow, almost everything you said is false in one or more ways. Let me explain:
First, there is technically no disease known as “breast cancer.” There are multiple forms of cancer that can affect breast tissue, so it is more accurate to refer to the “breast cancers.” And guess what? They behave differently. Like I stated above (and you did not challenge), inflammatory breast cancer is one kind of BC. It’s also the kind with the highest fatality rate, but it’s also the kind LEAST likely to be detected via mammography. Again, like I pointed out above, the type of BC most likely to be discovered via a mammogram (DCIS) is the type LEAST likely to kill you.
And the data is not on your side. Mammography started to become widespread in the late 80s into the 90s. However, if you look at yearly BC deaths, they did not start to meaningfully decrease until the mid 2000s – and that reduction is largely credited to better treatments and drugs.
Also, you are totally incorrect re: WOC and cancer risk. You talk about WOC having lower screening rates, but that only accounts for their diagnosis disparity, not their higher likelihood of developing cancer in the first place. There have been multiple studies (including from the NIH!) that have concluded that WOC face greater cancer risk because of higher exposure to environmental carcinogens in their homes, communities and jobs.
My mom was diagnosed with stage 4 breast cancer at age 57. She died at age 59. That was 26 years ago. I’m 64 now and had my first mammogram at age 38, and annual ones since then. I believe a baseline mammogram should be done even earlier to have a comparison later down the road.
I know women that don’t get mammograms because of scary stories they heard and how much it hurts. I never found them painful, uncomfortable yes, awkward yes, but painful not. Especially with today’s technology, compare to when I started having my mammograms. I guess it also depends on your sensitivity level and mindset. To me a bit of discomfort is worth early detection and saving lives.
I’m glad they are reverting to 40 as the starting age. But what I think is missing from the article summary is that the new recommendation also changes the current yearly screening, to every 2 years instead. So in the end, they will actually be providing fewer mammograms over a woman’s life.
Also wanted to add (as a woman who required a double mastectomy), do not rely on mammograms alone if you have dense breast tissue (the white images it produces can mask a tumor which also shows as white), but try to get an ultrasound as well. I am thankful I did.
I’ve been getting mammograms since I was 40. I’m 44 and just got a biopsy back that showed no cancer, but I have the abnormal cells that are high risk and can lead to ductal carcinoma in situ (DCIS). I’m now waiting for the referral to go through so I can consult with a specialist/ surgeon. It’s either I get rid of the abnormal cells now, or I subject myself to more biopsies down the road and more frequent mammograms. I’m opting for the surgery.
I found breast cancer at 34. I am glad they’re changing it to 40 but we need greater awareness on what women should look for. Just note changes and be aware. Please get your mammograms. They suck, I know, but one could save your life.
That is a huge age drop! I hope they look at other diseases that affect women only (cervical, uterine, ovarian cancers, etc.) and start those tests earlier. In fact, there is still no good test for ovarian cancer! Much more research money needs to be allocated for that alone.
I think it’s important to have early screening and detection. I also started having yearly mammograms at age 40. Some drs have also recommended to have colon cancer screening earlier than 50.
The headline is incorrect. The USPSTF says that mammograms should start at age 40, yes, but NOT annually. They recommend a mammo every OTHER year.
Every other reputable organization, including the American Cancer Society, Society of Breast Imaging, American College of Radiology, American College of Obstetricians and Gynecologists, American Medical Association, and American Society of Clinical Oncology, advocate for ANNUAL screening as the optimal tool for early detection.
The ONLY confusion is coming from USPSTF. They created confusion years ago with the “age 50, every two years” recommendation, which caused outrage in healthcare and — as was predicted — deaths. Now they’re changing only ONE part of their stupid guideline by lowering the age to 40. Every other org is exactly consistent and has been for a long time.
ANNUAL mammograms, starting at age 40, save lives.