FAQs

The United States Preventive Services Task Force (USPSTF) has recommended that women wait until age 50 to start mammograms and repeat mammograms every two years instead of every year. The USPSTF is a government-appointed task force made up of primary-care physicians and non-physicians. Their mission is to publish evidence-based guideline for medical care. However, none of the doctors on the task force specialize in breast cancer. We believe this has impaired the committee’s judgment. They’ve made recommendations without the input of expert physicians.

Several major health organizations still recommend women begin mammograms at 40. They include:

• The National Comprehensive Cancer Network (NCCN). An alliance of 27 of the world's leading cancer centers whose focus is creating better and more effective cancer treatments.
• The Mayo Clinic. The world's largest non-profit medical group. Their goal is to ensure patients receive the best health care possible through state-of-the-art clinical practices and medical research.
• American College of Radiology. An association of doctors and technicians specializing in radiology and medical imaging. Their members include diagnostic radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians, and medical physicists.
• Society of Breast Imaging. A group of radiologists, medical physicists, and technicians dedicated to combating breast cancer by improving techniques for early detection. They are strongly opposed to the USPSTF's mammogram guidelines.
• American Congress of Obstetricians and Gynecologists. A professional membership organization dedicated to the improvement of women's health.

The USPSTF has not provided a clear explanation as to why they've made their recommendation to start screening at age 50, but the evidence suggests they may have been swayed by a Canadian cancer study that claimed mammograms were not effective in women 40-49. The study examined a group of breast cancer patients over a span of 25 years and concluded that mammograms did not increase a woman's chance of survival.

This Canadian study was seriously flawed. It was performed using outdated equipment and its doctors and technicians were poorly trained. Its conclusions are also highly suspect. The second major flaw of the study is a nurse examined all participants before they were assigned to the group that received a mammogram or to the group that did not receive a mammogram. As it turned out, more women with suspicious breast lumps were assigned to the group receiving a mammogram.

There was no benefit from mammography screening when more women who already had advanced breast cancer were diverted to the group was to receive a mammogram. In fact, the study reports that 19 of 24 patients with advanced breast cancer were directed to the group that received a mammogram. This diversion of patients with obvious breast cancer into the group receiving a mammogram in part explains their astonishing conclusion that 22% of breast cancers would “disappear” without treatment. This is a startling conclusion considering there has never been a single documented case of a breast cancer disappearing without standard treatment.

It was this series of flaws in study design that lead the inaccurate conclusion that screening mammography in the 40-50 age group caused more harm than good, when in fact a more recent study from Canada demonstrates a 40% reduction in breast cancer mortality for women who undergo yearly screening starting at age 40.

If they had examined the study with breast cancer experts, they may have discovered the same flaws we did. The reason the researchers thought mammograms didn't affect the death rate was because all the patients were screened by nurses before the study started. Women with obvious cancer symptoms were funneled into the group that received mammograms, and the women without cancer symptoms were sent into the group that didn't. This altered the study's outcome and disguised the role mammograms play in saving lives.

- Dr. John West, Breast Surgeon

The decision to start mammogram screenings is a personal one and should be made by women based on their family history and their risk factors, such as a strong family history of breast and ovarian cancer or undergoing chest wall radiation at a young age.

For most women, the general rule is you should start screening ten years earlier than the age your first-degree relative was when they were diagnosed with breast cancer. For example, if your mother or sister was diagnosed when they were 45 you should begin discussions with your physician at age 35. 

Women with dense breasts are more at risk for cancer. Dense breast tissue also makes it more difficult to detect breast cancer using mammography. We recommend that women with dense breasts consider additional imaging techniques such as whole breast ultrasound or a breast MRI, especially if they have a family history of breast cancer.

The easiest way to reduce your risk of developing breast cancer is a balanced diet and regular exercise. Breast cancer is more common in women who are obese and sedentary. Recent studies have also shown that consuming three or more alcoholic drinks per week will increase your risk. Smoking also increases a woman's risk. There are controllable and uncontrollable risk factors associated with breast cancer. We recommnend talking to your physician about your risk.

Until recently, genetic testing was limited to women with very strong family histories of breast cancer and ovarian cancer. The price of genetic testing has decreased dramatially within the last few years.