Women ages 50 to 74 should receive a mammogram every two years, while mammograms for women in their 40s should be based on "informed, individualized decision making," as the procedure has the capacity to do more harm than good for those individuals, according to draft recommendations released on Monday by the U.S. Preventive Services Task Force (USPSTF).
USPSTF based its recommendations on an analysis of eight major studies on mammography screening conducted in the United States, the United Kingdom, Canada, and Sweden. The guidelines are intended for women who:
- Are at least 40 years old;
- Have no symptoms or signs of breast cancer;
- Have not been previously diagnosed with high-risk breast cancer lesion;
- Do not have a known genetic tendency to develop breast cancer; and
- Were not exposed to chest radiation when they were younger.
According to Associated Press, the recommendations were "largely a rewording" of those issued by USPSTF in 2009. Those recommendations discouraged women ages 40 to 49 from receiving mammograms.
By contrast, the new draft recommendations stated that the decision for such women "should be an individual one, recognizing the potential benefits, as well as the potential harms."
However, the task force said that "most will not" benefit from mammograms "while others will be harmed," with such harms including women undergoing chemotherapy, radiation, or surgery for cancers that do not threaten their health. USPSTF also cited the risk of over-diagnosis (Robeznieks, Modern Healthcare, 4/20 [subscription required]; Neergaard, AP/U-T San Diego, 4/21; Burton, Wall Street Journal, 4/20).
The takeaway: Women under age 50 should think critically before undergoing a mammogram, according to new recommendations by the USPSTF, as the procedure could end up being more harmful than beneficial to such women.
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