The U.S. Preventive Services Task Force announced Tuesday that guidelines for mammograms were changing based on recent research.
The new draft guidelines, which are open for public comment until June 6, recommends that women start getting screened for breast cancer at 40 instead of 50, and those at “average” risk get screened every other year.
Breast cancer is the second-most common type of cancer in women, and the second-leading cause of cancer death in the United States and Georgia. According to the American Cancer Society, 1 in 8 women will develop the cancer in their lifetime, and the disease accounts for a third of all diagnosed cancers.
The ACS projects that 300,590 new breast cancer cases will be diagnosed this year, up by 4.2% from last year’s estimates.
The recommendation states that women ages 40-74 should get a mammogram every other year, based on “at least fair evidence that the service improves important health outcomes,” per the draft. The same recommendation does not apply to women 75 and older because of what the group saw as inconclusive data. The recommendation is an update on the 2016 ruling, which encouraged screening to begin at age 50.
Incidence had gradually increased among women ages 40-49 from 2000 to 2015 but increased more noticeably from 2015 to 2019, with a 2% average annual increase, per National Cancer Institute data.
Research shows non-Hispanic white women and Black women have the highest rates of breast cancer. Black women tend to have more aggressive tumors and are 40% more likely to die from the disease.
“Today is a monumental day for the breast health community,” said Dr. Matt Miller, a radiologist and breast imaging specialist at Allegheny Health Network.
He called the recommendation a big step forward, but incomplete, because the data shows that annual screenings save the most lives.
“I’m hoping that in the near future, the USPSTF will update the draft and recommend annual screenings,” he said.
Recognizing that Black women tend to die at higher rates, he expressed hope this recommendation for earlier screening will bridge the gap and lead to lives saved.
“Studies are starting to show more obviously that minorities are more likely to die from breast cancer than non-minorities,” he said. “It’s really important that minority patients get screened every year,” he said, instead of the biennial recommendation.
Miller also said the recent USPSTF recommendation will help clear up confusion about varying guidelines: Many nurses and physicians have been recommending screenings starting at 40, and even earlier for high-risk patients with a family history of the disease or particularly dense breast tissue, he said. The recommendation is a step toward consistency in patient care.
While much of this research is conducted on cisgender women, anyone can get breast cancer, and transgender people are affected by the ruling as well.
Miller said transgender men who have not had top surgery should follow screening recommendations the same as cisgender females; that is, to start screening at age 40, or earlier if they are high risk. People who have had top surgery or mastectomies for other reasons do not need mammograms.
For transgender women, he said that those “who have taken hormonal therapy to develop breast tissue should start getting mammograms after being on hormone therapy for five years,” and added that research is still being conducted.
For patients who develop breast cancer in their 40s, this ruling will save their lives, he said. “This was a big victory today.”
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