Yesterday, the United Services Preventive Services Task Force released new guidelines recommending that women start regular breast screening at 50, not 40. They also recommend that women between the ages of 50 and 74 have mammograms every second year as opposed to annually, and that doctors stop teaching their patients to perform breast self-examinations (BSEs).
The reason behind these reversals? The task force says “there is moderate certainty” that the net benefit of bi-annual screening for women under the age of 50 is small and that false-positive test results – more common for women aged 40 to 49 – can cause unnecessary distress (no doubt). They also state that “adequate evidence suggests that teaching BSE does not reduce breast cancer mortality.”
So what does this mean for those of us south of the border? In a nutshell, not a lot. The new U.S. recommendations for mammograms mirror the current recommendations of the Canadian Cancer Society: Women older than 40 should receive clinical breast exams from a health care provider at least every two years; women aged 50 to 69 should have a mammogram every two years. And the Canadian Breast Cancer Foundation notes that our own Canadian Task Force on Preventive Health concluded back in 2001 that there was not enough evidence to conclude that BSEs were an effective early screening tool. (That said, I’m a fan of the breast aware approach advocated by both the Canadian Breast Cancer Foundation and the Canadian Cancer Society).
While our own breast screening recommendations may sound straightforward, mammography programs vary by province and women at greater risk for the disease need to talk to their doctors about whether they should start screening earlier. Look for more on this crucial health issue in the February 2010 issue of Chatelaine.