By Steve Blanchard - May 09, 2023
Today, the United States Preventive Services Task Force (USPSTF) issued new draft guidelines for breast cancer screenings, suggesting that women get screened every other year starting at age 40. The previous recommendation was for screening every other year starting at age 50 for those at average risk, and women 40 to 49 were urged to talk to their doctor about when to start.
Members of the American College of Radiology, Society of Breast Imaging and the National Comprehensive Cancer Network continue to recommend that women get screened every year.
“All women, regardless of race, should begin getting annual mammograms no later than age 40,” said Dr. Bethany Niell, section chief of breast imaging at Moffitt Cancer Center. “Women at increased risk may need to begin breast cancer screening exams as early as age 25. Our goal is to decrease deaths from breast cancer. To save the most lives, mammograms should be done every year, not every other year, and mammograms should start at age 40, not 50.”
"Our goal is to decrease deaths from breast cancer. To save the most lives, mammograms should be done every year, not every other year, and mammograms should start at age 40, not 50."- Dr. Bethany Niell, Section Chief of Breast Imaging
Delayed screening until the age of 50 contributes to health disparities in the Black and African American community, Niell said.
“Beginning screening at age 50 as previously recommended by the task force results in fewer lives saved,” Niell said. “This is especially detrimental to Black women because they are more likely to be diagnosed with breast cancer at a younger age.”
Some important factors to consider:
- Prior to age 50, minority women are 127% more likely to die of breast cancer; 72% more likely to be diagnosed with breast cancer; and 58% more likely to be diagnosed with advanced stage breast cancer.
- Black women are 42% more likely to die from breast cancer despite roughly equal incidence rates.
- Black women are less likely to be diagnosed with early stage breast cancer but twice as likely to die of early breast cancers.
- Black women have a two-fold higher risk of aggressive — “triple-negative” — breast tumors and a higher risk of BRCA1 and BRCA2 genetic mutations (placing them at higher risk).
“We are glad the USPSTF is recognizing mounting evidence that Black women develop and die from breast cancer prior to age 50 — and even age 40 — more often than white women,” the American College of Radiology said in a statement.
“Unfortunately, these new U.S. Preventive Services Task Force guidelines, recommending screening every two years instead of every year, will continue to contribute to breast cancer disparities for minority women by giving cancers another year to grow before they are detected,” Niell said.
These newly issued guidelines apply to women at average risk of developing breast cancer during their lifetime.
“If you have risk factors for breast cancer, these guidelines do not apply to you,” Niell said. “It’s really important that each of us understands our cancer risk factors.”
Women and men who are at higher risk of breast cancer should undergo a risk assessment at 25. If they are found to be at increased risk, they would be more likely to be eligible for earlier screening with mammograms and MRIs.
Transgender individuals, who are not mentioned in these revised recommendations, should also consider themselves at potentially increased risk, according to Niell.
“Transgender people who use hormones and/or have had surgeries may be at increased risk of breast cancer,” Niell said. “They should follow separate guidelines based upon their risk factors.
“Although these revised guidelines are a step in the right direction, I wish that the U.S. Preventive Services Task Force had followed the data that they cited. Mammograms every year, not every other year, starting at age 40 would save more