New guidelines for when to start mammograms

Most women believe regular mammograms are the key to preventing breast cancer. But experts don’t always agree about when women should begin having regular mammograms. This has created confusion about the right time to start this important screening.

Why the confusion?

Breast cancer is the second leading cause of cancer deaths among American women, but it doesn’t have to be. When it comes to successful breast cancer treatment, health care groups know screening and early detection are important. But they interpret mammogram risks and benefits differently when making recommendations.

For example, the U.S. Preventive Services Task Force suggests women begin regular mammograms at age 50. The American Cancer Society recommends age 45. Both organizations take the following into account:

Mammography benefits:

  • Mammography has helped lower breast cancer deaths by 40 percent since 2009.
  • One cancer is found for every 200 mammograms.
  • The benefits of mammography screening outweigh the risk for women aged 50-74.

Mammography risks:

  • Screening exposes women to small amounts of radiation. The exposure adds up over time.
  • Mammography can find lumps that look suspicious but are not cancerous. This can lead to unnecessary testing and procedures.
  • Mammography may not identify cancer in women who have dense breasts.

Is there a right answer?

In June, the American College of Obstetricians and Gynecologists (ACOG) revised their guidelines for women of average breast cancer risk*. The ACOG guidelines put the decision of when to start mammograms in the hands of patients and their health providers. The guidelines try to balance benefits and risks by advising health providers to:

  • Begin discussing the pros and cons of screening mammograms with patients starting at age 40
  • Allow patients to opt in for mammograms starting at age 40 once they understand risks and benefits
  • Urge women to have their initial mammogram no later than age 50

WISDOM study aims to end mammography debate

UCLA is participating in the Women Informed to Screen Depending on Measures of Risk (WISDOM) Study. This University of California study is exploring whether age-based annual screening is more effective than a personalized screening approach like ACOG recommends.

The five-year study hopes to:

  • Reduce the number of false biopsies and breast cancer scares
  • Identify more breast cancer cases in their earliest, most treatable state
  • Enroll 100,000 women and provide them access to genetic testing and other diagnostic advances
  • Identify one screening guideline that all experts can agree on

If you are in — or approaching — your 40s, talk with your doctor to determine when to begin mammography screening and how frequently you should be screened. And, visit WISDOM online for more information, or to join the study.

Make an appointment with UCLA Breast Health to receive personalized, multidisciplinary breast health care in a compassionate and supportive environment.

* These guidelines do not apply to women with risk factors, like a BRCA-gene mutation or a strong family history. For these women, there are different – more aggressive – screening recommendations.

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