You’ve probably heard the news that the U.S. Preventive Services Task Force has changed its recommendations about who should get mammograms, and how often. And you may be wondering what this means for you. If you’re 50 or older, should you only get mammograms once every two years as the new guidelines recommend? If you’re under 50, should you get a mammogram at all?

The first thing to understand is that the guidelines are general and may not apply to your situation. Only your own physician can say whether you should still get mammograms and whether you should get one on an annual or bi-annual basis.

The second thing to understand is that the new guidelines have not yet been endorsed by the American College of Obstetricians and Gynecologists (ACOG).

The American College of Obstetricians and Gynecologists continues to recommend:

* Screening mammography every 1-2 years for women aged 40-49 years

* Screening mammography every year for women aged 50 years or older.

So why don’t the two authorities agree? There is evidence that supports both points of view. The American College of Obstetricians and Gynecologists appears to be relying on the ability of mammograms to detect cancer at an earlier age, allowing for early treatment. The U.S. Preventive Services Task Force considered evidence that early detection didn’t necessarily result in fewer breast cancer deaths and could lead to women experiencing unnecessary fear and anxiety when mammograms detect benign lumps.

My personal recommendation as a physician? I believe that early detection is the way to go. All of the actuarial tables relied upon by the U. S. Preventive Services Task Force do not put me at ease when I am recommending a certain course of management for my patients. Therefore, I would recommend continuing to have a screening mammography every two years, if you are younger than 50 years of age and every year for women 50 and older. I don’t believe that the endpoint should just be breast cancer deaths. One needs to take into consideration the quality of life regarding the different treatment modalities and the psychological toll of being diagnosed with breast cancer, whether you die from the disease or not. Early detection will minimize that risk. So, I would recommend what the National Cancer Institute and ACOG now recommend, and that is the regimen presently being used for screening. However, discuss this important and potentially life-saving test with your own doctor. Only your personal physician knows your history and your risk factors. Only your personal physician can determine what’s best for you.

– Yvonne S. Thornton, MD, MPH