Dr. Jacqueline Gerhart: Mammograms Gold Standard For Breast Cancer Screening

UW Health Family Medicine physician Dr. Jacqueline GerhartMadison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.


Dear Readers: I've gotten a few mammogram-related questions, so I am going to combine them in this week's column.


I have breast pain but I'm not due for a mammogram. Should I get one anyway?


My sister needed a breast ultrasound. How do I know if I need an ultrasound or a mammogram?


I've seen ads that say I need a mammogram starting at age 40. Can I start earlier than that? My mother had breast cancer.


I'm glad to hear so many of you are concerned about breast health, breast cancer and mammograms.

Mammograms are the gold standard for breast cancer screening in America. But there are conflicting guidelines for what age you should start, how often you should get them and at what age you can stop.


For you National Football League fans, perhaps you have noticed the bright pink accessories worn by players, coaches and referees. The pink items will be worn during the month of October to mark Breast Cancer Awareness month.


The NFL has partnered with the American Cancer Society for a campaign called "A Crucial Catch: Annual Screening Saves Lives." You may notice the word "annual" in the title. This is because ACS guidelines recommend yearly mammograms starting at age 40 for women of average breast cancer risk.


However, this is in conflict with the guidelines from our country's preventive medicine experts. The U.S. Preventive Services Task Force states the following:

  1. Screening mammograms should be done every two years, beginning at age 50, for women with average breast cancer risk.
  2. Screening mammograms before age 50 should not be done routinely.
  3. Doctors should not teach women to do breast self-exams.
  4. There is insufficient evidence that mammogram screening is effective for women age 75 and older.

Of note, the American College of Radiology and the Society of Breast Imaging both support the ACS guidelines of starting annual screenings at age 40. They also state that women who are at high risk (those with proven genetic changes linked to breast cancer) should start screenings at age 30 - or 10 years younger than their mother/relative was diagnosed.


The ACR also states that ultrasound or MRI can be considered for high-risk women, those with dense breast tissue, or those with concerning findings on a mammogram.


Finally, if you have breast pain, a screening mammogram does not apply to you. The above guidelines apply to screening a person with no symptoms.


If you have pain, a lump or breast changes, you need to see your health care provider for a breast exam. The physician or provider will then determine if you need further testing, regardless of your age.


In summary, since guidelines from national health care organizations differ, talk to your physician about your personal breast cancer risks and your current symptoms. Then, you and your doctor can jointly determine how best to lower your breast cancer risk.

This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.

Date Published: 10/16/2012

News tag(s):  jacqueline l gerhart

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