While there's no doubt about the health value of breast cancer screenings, expert opinions vary on recommended ages for screenings and how often to get checked. The American Cancer Society recently issued new guidelines, which notably differ from other leading medical organizations.
For tips on applying these guidelines to your own health, we discussed mammography with Dr. Chelle Moat, a Premera medical director.
Mammogram guidelines for women
“Mammography exams can detect pre-symptomatic breast cancer and the benefits of screening helps save lives by diagnosing breast cancer early,” said Dr. Moat. “But there can be risks in screening as well, such as false positives that can lead to a biopsy procedure, which can bring on a great deal of stress and anxiety.”
Based on recent breast cancer risk research, the American Cancer Society's new guidelines now suggest that women start mammogram screening at age 45, rather than age 40, as previously recommended.
These guidelines differ from those of the U.S. Preventive Services Task Force, which recommends that an average woman undergo a screening mammography every two years between the ages of 50 and 74 years. The Task Force also states that the decision to use mammography for screening between the ages of 40- 49 should be individualized based on an individual's personal health situation.
Is there harm in beginning screening early? Dr. Moat explains that the biggest risk is an increased number of false positive tests, which result in breast biopsies and unnecessary stress. However, women with a higher risk of breast cancer need to start preventive screenings earlier. The bottom line is to consult with your doctor on when to begin screening and how frequently to schedule them.
Breast cancer risk factors to consider
The primary factor to gauge your breast cancer risk, and when to begin screening, is your family history. First-degree and second-degree relatives (mother, aunt, sister) who've had breast cancer at an early age (generally before age 50) are one factor your doctor will consider. According to the U.S. Preventive Services Task Force, women 40 to 49 years of age with a first-degree relative with breast cancer have a risk of breast cancer similar to those s 50 to 59 years of age without a family history.
If you don't know your family's medical history or want to better understand specific factors, this online risk calculator lets you fill in specific parameters to provide recommendations.
“If a woman has a strong family history of breast cancer (or ovarian cancer) that is on the same side of the family and occurred at an early age, then they are more likely to develop the disease. But the ultimate decision on when to start and how frequently you get a mammogram is an individual choice that women should make with their doctor,” says Dr. Moat.
According to the Breast Cancer Foundation, about 40 percent of diagnosed breast cancers are detected by women who feel a lump. “Women who pay attention to their bodies know best when something doesn't feel right, so establishing a regular self-exam is still very important,” says Dr. Moat.
Annual breast cancer screening coverage
Breast cancer screening is important for long-term health and many health plans cover a preventive screening at little or no cost. That's true for Premera members, whose plans cover screening mammograms, when ordered by a doctor. While screening mammograms are a covered preventive benefit (meaning little to no costs to you) in most plans, you'll need to check your specific plan for details.
“Ultimately, women will make a decision (with their doctor) on when to start screening and we'll cover it because we never want to be a barrier to any women getting the preventives services they need,” said Dr. Moat.
To check your plan's coverage, log into your online member account or feel free to call customer service at 800-722-1471 with questions about costs and coverage. Keep in mind that you may be responsible for part of the costs for non-preventive exams or services (such as diagnostic tests to evaluate symptoms).