Guidance on Screening Mammography

Mammography: The Westerly Hospital Recommends Continued Screening Annually Beginning at Age 40

In 2009, the U.S. Preventive Services Task Force (USPSTF) reversed its 2002 position and no longer recommends annual screening mammography for women aged 40-49. For women in their 50s and beyond, the Task Force suggests mammography every two years. The American Cancer Society, however, continues to advise women to get an annual screening mammography beginning at age 40.

The issue about mammography is whether the risks of getting an annual mammogram outweigh the benefits for women aged 40-49. Most physicians agree and research shows that the maximal effects of mammography in terms of “lives saved” are seen in women aged 50-70, partly because the incidence of breast cancer increases with age. More mammograms need to be done on women aged 40-49 to result in lives saved compared to the older group.

The concern about screening women aged 40-49 is that screenings may result in more “false positives” which can lead to further and sometimes ultimately unnecessary testing (diagnostic testing such as breast MRIs and breast biopsies) and may cause women undue anxiety, as well as unnecessary costs.

According to Robert Legare, MD, medical oncologist on staff at The Westerly Hospital, ideally, the decision to begin mammography at age 40 rests with a patient and her physician and is based on discussion of a woman’s individual risk factors and preferences. Deferred screening may be considered for a woman who has no personal risk factors or family history. “If there are personal or family history issues, screening women ages 40 to 50 remains critical. While I hope the USPSTF recommendations continue to create dialogue about screening, at this time, it seems reasonable to continue to begin screening at age 40,” said Legare. Jeffrey Christian, M.D., general surgeon on staff at The Westerly Hospital and Chairman of the Hospital’s Breast Cancer Board agrees.

According to the American Cancer Society, failure to routinely screen women in their 40s could reverse the progress that has been made over the past 20 years in reducing deaths from breast cancer and stands by its recommendation that women ages 40-49 have an annual mammogram. While recognizing that mammography has deficiencies as a screening tool for these women, the ACS notes that until a better screening is developed, the screening mammography remains the best tool for early detection.

Both Drs. Legare and Christian maintain that if women choose to defer screening until age 50, “we will no doubt miss early detection of some breast cancers in women in the 40 to 50 age group and this could lead to death from breast cancer for some women.” Therefore, while both emphasize the importance of women in the 40 to 50 age group working with their physicians to review the risks and benefits of screening, both continue to fully endorse screening for all women beginning at age 40.

To make an appointment for your annual mammogram, call our Diagnostic Imaging Department at 401-348-3292.

Learn more about our breast health services.