Women & Infants Hospital of Rhode Island has issued the following position statement in response to this week’s report from the United States Prevention Services Task Force which recommends women over the age of 50 have mammograms every other year, instead of annual screenings starting at age 40:
According to Dr. Robert Legare, MD, director of the Breast Health Center in the Women & Infants’ Program in Women’s Oncology, there is a definite role for screening mammograms in women starting at age 40.
Web-Exclusive Q&A: New Mammogram Guidelines
We acknowledge the limitations of mammography, but it remains our best tool for early detection and successful treatment of breast cancer. Since 1990, the breast cancer mortality rate in the United States has been steadily declining, primarily due to screening mammography.
While mammographic screening realizes maximum effect in terms of lives saved in women aged 50 to 74 years, most research still indicates at least a 15% reduction in mortality from breast cancer in women aged 40 to 49 years screened with annual mammography.
We have known that screening is more challenging in younger women, in part because the incidence of breast cancer is less in this age group but also because younger women have dense breast tissue which limits the sensitivity of mammography. The risk of mammography in younger women relates to the “false positive” result that can lead to additional imaging, possible needle biopsy and more frequent follow up. This may add to some women’s anxiety, while others may in fact be reassured.
However, when there are personal risk factors or family history, women should begin screening at least at the age of 40. In addition, there is no question that if great numbers of women delay mammography to age 50, there will be delays in diagnosis which will impact survival.
We should also take this time to focus on the approximate 30% of women over the age of 40 who are not undergoing mammographic screening and ensure appropriate education and resources. We should advocate for and insist upon equal access to screening for our under-served populations.
We hope the USPSTF recommendations continue to increase dialogue on the benefits and limitations of screening and acknowledge a great need for more effective screening approaches and individualized recommendations.
While we will continue to study this issue in depth, at this time, Women & infants Hospital of Rhode Island will continue to recommend screening mammography beginning at age 40.