New mammogram advice: What you need to know

The U.S. Preventive Services Task Force, a panel of experts that issues guidelines on preventive care, It recommended that all women begin routine breast cancer screening at the age of 40instead of 50, the previous recommendation.

The committee continues to advise spaced exams at two-year intervals, although some other medical organizations endorse annual mammograms.

Here’s more about what this means for you.

Who is affected by the new guidelines?

The advice applies to all “women of gender and other persons designated female at birth” who are at an average risk of developing breast cancer and who do not have any worrisome symptoms that might indicate breast cancer. This group includes women who have dense breast tissue and have a family history of breast cancer.

The recommendation does not apply to anyone who already has breast cancer, has genetic mutations that increase the risk of breast cancer, has received high-dose radiation to the chest, or has had breast lesions identified in previous biopsies.

Why did the task force change its advice?

The committee based its advice on the latest and most comprehensive science on breast cancer in women under the age of 50. Although no new clinical trial data were available — and only one older trial included a significant proportion of black women — the panel commissioned a review of screening strategies and modeling studies to reach its conclusions.

Experts also took into account the higher death rates among black women. Those diagnosed with breast cancer in their 40s have twice the mortality rate of white women.

Why aren’t mammograms done annually?

When the task force makes recommendations, it tries to balance the benefits of mammography — saving lives — against the potential harms. These include false-positive results that cause anxiety and lead to additional testing and invasive procedures, as well as overdiagnosis—the potential for women to be treated for “indolent” tumors that grow slowly and will never become life-threatening. A mammogram also exposes the breast to radiation.

Mammograms save lives, but the committee’s research found no more benefit from annual mammograms than biennial screenings. They concluded that annual mammograms were no better at detecting stage 2 cancers and other serious tumors. Modeling studies estimated that biannual scans provided a better benefit-harm ratio.

Will my insurance cover this?

Insurance companies are already legally required to cover mammograms in full each year for women who want one. This recommendation will not change that.

Does early screening save lives?

The task force’s review of screening strategies indicated that the change could increase the survival rate by about 20 percent. Overall, screening every two years starting at age 40 and continuing until age 74 will prevent 1.3 additional breast cancer deaths per 1,000 women, compared to screening starting at age 50.

The benefits may be even greater for black women: An additional 1.8 breast cancer deaths were averted per 1,000 women, according to the commission’s report.

When can I stop screening?

Women should continue screening until age 74. After that, it’s not clear, because there are no data on women 75 or older. The consensus seems to be that if a woman is in good health and has a life expectancy of at least another 10 years, she should continue to receive mammograms.