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Mammograms at Age 40: A response to ACS recommendations

Wellman-Danielle-splashThis week, the American Cancer Society (ACS) announced new recommendations about when women should begin annual mammogram screenings. We believe this will spark important dialogue between women and their primary healthcare provider about their breast health and their risk for breast cancer. It could also bring some confusion.

At Wake Radiology, we continue to believe that high quality annual mammography starting at age 40 remains a woman’s best chance of early detection of breast cancer and saving lives. 

This mirrors the comments made by Dr. Debra Monticciolo, Chair of the Breast Imaging Commission for the American College of Radiology.  According to the National Cancer Institute and the Centers for Disease Control, the risk of a woman age 40 – 50 developing breast cancer is 1/68. Burke-Eithn-splash

Women and their doctors should know that the American Cancer Society has always, and still does, state that annual mammography screening starting at age 40 saves the most lives. The US Preventive Services Task Force (USPSFT) also acknowledges this fact, as stated in their recent draft recommendations: “The USPSFT found adequate evidence that mammography screening reduces breast cancer mortality in women age 40 -74 years“.

The following are additional facts that we feel offer continued support for starting screening mammography age 40:

  • Long-term follow up in multiple studies have shown an 18-29% reduction in breast cancer mortality when annual screening is done between ages 40-50.
  • Mammography detected breast cancer in the 40-50 age group results in lower-stage disease detection which results in reduced treatment and lower rates of recurrence.
  • It is estimated that approximately 30% of the years of life lost to breast cancer is due breast cancer detected age 40-49.
  • Even if physicians and patients use an expanded definition of what is considered a high-risk screening, 66% of all malignancies in this age group would still be missed.
  • The advent of 3D mammography is improving cancer detection rates for mammography while decreasing false alarms. This technology also improves cancer detection in more dense breasts, a significant issue for the 40-45 age group. In addition, 3D mammograms are helping to reduce patient anxiety and, because of better image clarity, lower the need for additional tests.

All of the breast imaging radiologists at Wake Radiology are sensitive to the concerns raised by the ACS regarding the negative effects of recalling a patient for additional imaging and of the stress and expense associated with even a benign biopsy. We always strive to minimize these.

At Wake Radiology, we feel strongly that the best way to reduce cancer mortality remains screening mammography starting at age 40. Unfortunately, doctors can’t distinguish dangerous breast cancers from those that are non-life-threatening. While the incidence of breast cancer in the 40-year age group is lower than in older women, annual screening mammograms remain the best option for detecting cancer early and reducing the risk of death from breast cancer.

If a woman has questions about when to have her first mammogram or how often, we recommend patients talk with their primary care physician, an OB-GYN physician or a breast imaging specialist. For more information about screening mammogram, we recommend patients visit, and

Dr. Danielle Wellman and Dr. Eithne Burke

Co-Directors, Breast Imaging Services

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