When to start mammography
Screening Mammograms: When Do I Start Getting Them?
should you start getting mammograms at
40 45 50 what is this so confusing we
will teach you all about it
[Music]
both women and physicians are confused
and frustrated by the rollout of new
guidelines about when to start getting
screening mammograms and whether to get
them every year or every other year or
some other recommendation there is a
rationale for starting screening
mammograms later than 40 which is the
generally accepted guideline for many
years but I'm gonna explain to you why
we recommend you continue getting
screening mammograms every year starting
at 40 until the dust settles on the
issue in this lesson I'm going to show
you how mammograms save lives I'm also
going to go over some of the actual
risks of getting screening mammograms
I'm going to review some of the new
guidelines and the controversies
associated with them and I'm going to
teach you how to engage your physicians
so you can make the best decisions
before yourself so let's get started
so how do screening mammograms save
lives
well getting a mammogram when you don't
have a lump in your breast a screening
mammogram once a year when you have no
symptoms helps detect small breast
cancers and pre cancers before you or
your doctor can detect them and it makes
sense breast cancers when they're
earlier or less of a threat to you and
smaller breast cancers we can cure more
often than larger breast cancers so why
the controversy well it is kind of
complicated
and next I'm explaining to you the risk
of getting screening mammograms their
risk to getting a screening mammogram
well there are and I'm going to walk you
through them screening mammography
getting a mammogram every year when you
don't have any symptoms is really a
balance between the benefits saving
lives finding cancers earlier versus the
risk which would be the cost
the stress and anxiety of having extra
biopsies or the radiation from the
mammography so let me walk you through
some of the risks that are talked about
the most callbacks so when you undergo a
mammogram they take two views of each
breast you walk out the door and you get
a letter saying come on back we want to
take a little look into your breast the
radiologist a little bit worried about
something I wanted to clarify something
well that's stressful it also is
increased radiation to your breast and
nothing's found and you kind of feel
like you go through the wringer and
you're relieved but still you're put
through a process that's pretty common
biopsies 80% of all breast biopsies are
benign not cancerous so there are a lot
of biopsies that we order and recommend
based on something on a screening
mammogram that proved to be nothing so
there's an argument that many of these
biopsies were not needed to find cancer
some benign biopsies the stress and
anxiety of undergoing a mammogram the
discomfort callbacks biopsies all of
that but the personal distress there's a
financial cost sometimes to you and to
society of getting mammograms every year
for so many women and then there's an
argument that some cancers would be
detected earlier but even if they're
detected in six months when doctors
could feel them or you could feel them
both would be cured it's a weird
argument it's hard to apply to
individuals so there's a lot of concern
about screening mammograms and whether
the risk
Orla less than the benefits that's where
mammogram screening guidelines come in
to give recommendations looking at all
of the benefits in the risk and that's
what I'm going to cover next and
unfortunately they're still confusing so
what are the new guidelines or
recommendations for getting screening
mammograms when to start how frequently
to get them
well guidelines are issued by
well-meaning societies and governmental
organizations composed of smart
physicians nurses epidemiologists public
policy people
number crunchers to make recommendations
and for many many many years the gold
standard was really considered the
American Cancer Society's
recommendations get a mammogram at the
age of 40 and annually going forward
simple to follow easy to remember it
worked
about five years ago the United States
Preventive Services Task Force say that
fast issued new guidelines suggesting
that women start Mamet mammograms at the
age of 50 in between 50 and 74 get a
mammogram every other year and something
different afterwards and no
recommendation in there when women are
in their 40s except for if they're
deemed at high risk but there's no
standard way to identify people that are
at high risk that created a big uproar a
lot of confusion it was so complicated
that physicians didn't learn it patients
couldn't learn and there's a lot of
political fallout a few years later the
American Cancer Society also issued new
guidelines beginning meant recommending
beginning mammograms at the age of 45
and every year until 55 and after 55
every other year and then that was also
confusing all of this is important to
put together is that all these
recommendations suggest that physicians
identify women that are considered
high-risk in their lifetime for getting
breast cancer and that is a difficult
task to really quantitate and figure out
whether a woman's high risk to get
mammograms on 40s based on the new
guidelines or a little elevated risk but
not high enough to do this so the
guidelines suggest beginning mammography
later identifying women that are at high
risk but all of it's so confusing it's
really created a lot of havoc in
healthcare so next I'm going to tell you
some general principles about getting
screening mammograms that we suggest
that incorporate all of
these principles what is the take-home
message about getting screaming
mammograms well making informed
decisions which is the principle behind
a breast cancer school for patients
applies here educate yourself you're
already doing this by watching this
video read through our content and the
links great links to many different
sites on this topic and look elsewhere
engage your physicians they know you
best ask them what their recommendation
is in general ask them what their
recommendation is for you maybe you're a
higher risk maybe you're a lower risk
ask them if they feel the benefits
outweigh the risk is starting at 40 or
45 or 50 so stepping back I'm doing my
best to make it simple is this these are
a couple principles
number one I generally recommend because
people or individuals not just society
it's easier to recommend something for
everyone but what you have to make a
decision about yourself that's a
different story start mammograms get
them annually at 40 until the dust
settles if you're in this camp where you
don't think that you're at high risk and
you want to avoid mammograms you don't
like the feel of our painful or you're
worried about the radiation or the risk
then maybe you start at 45 or 50 engage
your doctor and there's a rationale
behind that if you're at high risk you
carry the breast cancer gene or you had
biopsies that tell you're at high risk
where you have a very strong family
history of breast cancer ovarian cancer
and other things then I would certainly
err on screening earlier start in 40 and
going forward but again most importantly
engage your physicians on the topic ask
them what they think share them with
with them your thoughts and concerns and
make an informed decision for yourself
to learn more about when to start
screening mammograms visit the breast
cancer school for patients where we will
teach you everything you need to know
we're here to help you get the best
possible breast cancer care in your
community register on our website to get
our list of questions to prepare you for
your next doctor visit
