The US Preventative Task Force recently suggested changes to their breast cancer screening guidelines. The Task Force recommends women should begin getting screened every other year for breast cancer starting at age 40 (instead of their previous recommendation of 50). This change reflects the increasing rates of breast cancer among younger women and highlights the importance of early detection.
Responding to these new guidelines, Dr. Megan Baker, breast surgeon and medical director of the Roper St. Francis Cancer Center, said, “This is a much-anticipated correction of the 2009 US Preventive Services Task Force guidelines; however, many breast specialists feel it does not go far enough.”
Editor’s note: Roper St. Francis Breast Cancer experts follow the Society of Breast Imaging/American College of Radiology standards for screenings. The recommendation is yearly breast screening to start at age 40 and annually thereafter.
Increasing Rates of Breast Cancer
Between 2009 and today, only one more study was added to their analysis, yet the recommendations changed dramatically. So, what led to this shift? “What has changed is that the number of younger women developing breast cancer has increased an average of 1 percent per year. And in the past four years, it’s increased 2 percent per year,” noted Dr. Megan Baker.
Success in Early Detection
One of the biggest takeaways from these new guidelines is the importance of early detection. Successful breast cancer treatment is considerably more likely when the disease is caught early. By starting screenings earlier, we increase the chances of detecting and treating the cancer in its beginning stages, potentially saving a lot of lives.
Disparities in Mortality
In addition to the alarming rate of increase in breast cancer in younger women, there is a persistent concerning disparity. “We continue to see more aggressive types of cancers disproportionately affecting African-American women and women of color in all age groups, but particularly in the youngest women between 40-50 years of age,” Dr. Megan Baker points out.
The Task Force states that Black women face a 40 percent higher risk of dying from breast cancer compared to White women and frequently encounter aggressive forms of the disease at younger ages. There’s an urgent need for research to determine if alternative screening strategies might be more beneficial for women of color.
Addressing Concerns of Overdiagnosis
With the increased diagnosis, you might ask: is it just that we’re screening more? Dr. Baker clarifies, “Though it’s not clear why there’s an increase, it is tempting to attribute this to overdiagnosis and screening more women. In fact, that is not the case, but the actual cause remains elusive. Screening rates have declined since the 2009 Task Force recommended women start screening at 50. If this was overdiagnosis, you would expect to see detection of stage zero breast cancer (non-invasive, abnormal cells in milk ducts) in that young age group when in fact it’s actually a more serious type of invasive cancer.”
Addressing the Anxiety Concern
A controversial point of the previous guidelines was prioritizing anxiety reduction over mortality reduction. Dr. Baker passionately challenges this notion, “The Task Force acknowledged by recommending women get screened at 50 in 2009, they were giving up a 15 percent absolute mortality reduction in the 40-49-year-old age group. And they felt that giving up that reduction in death from breast cancer was justified by the savings of reduction of anxiety for breast cancer, benign biopsies or false positives.”
The choice between easing anxiety and actively pursuing one’s long-term health is personal. Yet, as Dr. Baker highlights, the previous guidelines may have underrepresented the importance of early screening, potentially to the detriment of countless women.
Speaking with your doctor about breast cancer screenings can provide insight into individual risk factors, helping you make the most informed decision possible. Anxiety is a natural emotion, but don’t let it be the barrier between you and potentially life-saving screenings. Prioritize your health, understand your risks and make informed decisions.
Schedule your mammogram today. To make your appointment, call us at (843) 402-5000.