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By Gaelyn Scuderi

M.D. on 05/21/2018

The Skinny on Screening Mammography

It’s common for me to field questions from both patients and referring providers about breast cancer detection with screening mammography. Common questions include: when should I start getting a mammogram? How often do I need one? And – because, let’s be honest, no one really looks forward to their mammogram – when can I stop? 

Answering these questions has become more difficult in recent years because screening for early breast cancer with mammography has fallen under some scrutiny. Much of the focus is related to healthcare economics and the push across all medical disciplines to practice population medicine. Screening mammography is also under a critical lens because, like all diagnostic tests, it is imperfect. The mammogram detects most, but unfortunately not all, early breast cancers.

As these questions about the population benefit and inherent imperfections of screening mammography have been raised, the questions of when to start, when to stop and the optimal frequency of screening have become more difficult to answer. As a result, there have been multiple sets of screening mammography guidelines published, all with differing recommendations. How confusing is that? 

Discussing the pros and cons of each of the different screening mammography guidelines out there is a topic I’m passionate about. But I want to spare you the in-depth details, and give you the skinny on which screening mammography guidelines I endorse in my mammography practice, and why. 

I encourage my patients to follow the American College of Radiology and Society of Breast Imaging (ACR/SBI) screening mammography guidelines. The reason is actually pretty simple: these recommendations save the most lives. Women who are screened under these guidelines see an outstanding 39% reduction in breast cancer mortality (compared to a lesser 31% reduction from American Cancer Society guidelines and a much lower 23% reduction from United States Preventative Services Task Force guidelines). The ACR/SBI recommends that women at average risk should receive a screening mammogram every year, beginning at age 40. Screening should stop only when there is limited life expectancy of less than 5-7 years, or if the woman cannot undergo biopsy or limited treatment of a cancer if found.

Though the ACR/SBI screening mammography guidelines help form the basis for my practice, it’s important to understand that we are all individuals, with unique needs and values. Your breast health care is personal, and these guidelines are meant to serve as a reference point upon which individual health care decisions can be made.

If you have questions about your breast health, don’t hesitate to contact our team at 904-880-5522 to discuss your personal breast cancer screening plan.

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