New breast exam guidelines

New breast exam guidelines

For Trisha Dalbec, the new recommendations could have meant a radical mastectomy or even death.

In 2008, Trisha, at age 45, found a lump during her monthly breast self-exam (BSE). She called her health provider and scheduled a mammogram, which showed abnormal cells. A biopsy of the suspicious tissue confirmed that Trisha had breast cancer. Trisha, a nurse practitioner at Ministry Medical Group in Tomahawk, underwent a lumpectomy. Since the cancer had already spread to her lymph nodes, she started chemotherapy and radiation therapy.

"As a women's health advocate, I highly stress the importance of breast self-exams and early screenings for my patients," said Trisha. "It's not a matter of recommendations; it's a matter of a woman’s health – a woman's life. If I had followed the new recommendations, a cure may not have been possible for me."

The United States Preventive Services Task Force (USPSTF) has announced that it does not recommend routine mammography screenings beginning at the age of 40 for women with average breast cancer risk; they also discounted the value of breast self-exams.

However, the American Cancer Society and the American Congress of Obstetricians and Gynecologists continue to recommend BSE and annual mammography screenings beginning at age 40. Caught early, breast cancer has a great cure rate. One in eight women will be diagnosed with breast cancer; only a small percentage will have a family history of the disease.

Women should be prepared for insurance companies to consider early mammography screenings as elective services.

If you have questions about breast health or breast cancer screenings, talk to your primary care or women’s health care physician / provider. You should discuss your specific situation and determine together what the best decision is for you. 

Other highlights of the new USPSTF recommendations include the following:

  • For women between the ages of 50 and 74 years, the USPSTF recommends mammography every two years (rather than every year).
  • The USPSTF notes that there is insufficient evidence to assess the benefit and harms of screening in women over the age of 74.
  • The USPSTF recommends against teaching breast self-exam.

Breast cancer can strike at any age. When treated early, breast cancer can be cured. Each woman should educate herself on the risks and benefits of screening.

U.S. Preventive Services Task Force. Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine. 2009; 151:716-726

American Cancer Society

Additional information on breast exam recommendations:

Susan G. Komen for the Cure

American Cancer Society

Mayo Clinic

American Congress of Obstetricians and Gynecologists

Agency for Healthcare Research and Quality

National Cancer Institute

American College of Radiology