October is National Breast Cancer Awareness Month in the U.S., and this is our third year of celebrating/discussing it in this blog.  In the blog about this during the past two years *, I’ve given a general summary about what is known about breast cancer – risk factors, diagnostic methods, recommendations for screening and prevention – but this year, I’m going to give you some new information. Information that will hopefully clear up the confusion from the past year.

What confusion am I referring to? Since last October, the US Preventive Services Task Force (USPSTF) came out with some recommendations about screening for breast cancer that created outrage in the medical community and confusion in the non-medical community. We were very strongly against several of their recommendations, as were all of the expert committees and organizations specializing in breast cancer, from the radiology societies, to the surgical societies to the major universities to the cancer societies. The recommendation that offended the most was the one that advised women to start having regular screening mammograms at age 50, rather than at age 40. We also disagreed with their recommendation that women should stop doing breast self-exam. (See Robin’s blog about this**)

Now comes a study that breast cancer experts believe should end the debate of when a woman should start having screening mammograms. A large and well done Swedish study*** showed that mammography screening in women ages 40-49 resulted in a much greater reduction in deaths from breast cancer than previously thought.  Considered to be the largest epidemiologic study of mammography in women in this age group, the study found that there was a 29% reduction in deaths from breast cancer due to mammographic screening.

The USPTF stated in their report/recommendations that there was only a 15% reduction in deaths from breast cancer, and therefore, screening efforts were not cost-effective. Most experts questioned that estimate, and many more (including us) questioned the appropriateness of the argument.

So, to all of you out there in the 40-49 year old age group, experts in breast health and breast cancer agree: the confusion should end.  You should start getting your regular mammograms at age 40 (or younger if you have certain risk factors, and your doctor recommends it). If you’re in this age group and were relieved by the USPTF’s recommendations, and planned not to start mammographic screenings until you were 50, please discuss this with your doctor. We and experts in the field do not believe that this is a wise decision.

*To read our blogs from the prior Octobers on general info about breast cancer:

http://www.smartwomanshealth.com/horn_miller_blog/?p=435

** http://www.smartwomanshealth.com/horn_miller_blog/?p=688

 ***Cancer. Published online September 29, 2010.