Breast Cancer Screening: Is 50 the New 40?

Woman in hospital gown walks to screening room

Studies show, 1 in 8 women will get breast cancer in their lifetime; and Oregon women are behind the national average for breast cancer screening. Scheduling a mammogram is a great way to start the new year off right.

But for women in their forties, screening guidelines can be confusing. For decades, many health care providers recommended women start getting mammograms at age 40. Now, the U.S. Preventive Services Task Force recommends starting at 50, while the American Cancer Society recommends starting at age 45. Both organizations emphasize that shared decision-making between women and their health care providers is key to decide whether to begin screening earlier.

These guidelines are for women at average risk for breast cancer. Breast cancer survivors and women with symptoms, like a new lump or discharge, should get a mammogram, regardless of age.

I'm at average risk. What should I do?

That's a decision you should make with your health care provider. We talked to Amy Cantor, M.D., M.P.H., about why there's no one-size-fits-all guideline for women in their 40s.

"The research shows that for women 50-69, mammograms significantly reduce the risk of dying of breast cancer," she says. "For women in their forties, the risk is not reduced significantly."

Moreover, mammograms aren't without risks. False positives are common, especially in younger women. Recent studies show that for every 1000 screening mammograms done on women in their forties, 125 have abnormal results. Of those, just two women will have cancer and two will have pre-cancer.

This could mean unnecessary anxiety and distress for 121 women in every 1000 screened. It also means unnecessary biopsies, which are invasive and have their own risks.

Statistics are great, but how does this apply to me?

"I talk about the benefits and risks of screening mammograms with all my patients in their forties," says Dr. Cantor. "Each woman responds differently."

For some women, getting screened reduces anxiety. For others, it does just the opposite.

Factors like family history of breast cancer often play a role in a woman's decision about when to start getting screened. But not all instances of cancer in a woman's family increase her risk.

"First-degree relatives are the most important, like a mother or sister," says Dr. Cantor. "If your aunt or a cousin is the only relative who had breast cancer, that doesn't impact your risk in the same way."

What about breast self-exams?

Self-exams are no longer recommended. Instead, the guidelines recommend that women practice breast self-awareness.

"Be aware of how your breasts look and feel," says Dr. Cantor. "Be familiar with the slight changes that may happen as your hormones fluctuate." If something changes outside of this normal rhythm, talk to your health care provider.