According to the Susan G. Komen Foundation for the Cure®, since the onset of regular mammography screening began in the early 1990s, the percentage of deaths from breast cancer has decreased by 30 percent. Dr. Chandler notes that the majority of medical data validating current standards, along with the decrease in deaths in the United States, confirms the efficacy of current guidelines. Mammography is not perfect. It does not find all cancers, but is accurate 85 to 90 percent of the time. At this point in time, it is the best test we can use on a practical basis and on a large number of women. whaT are The currenT guidelines and who endorses Them? These guidelines, which have been considered the “gold standard” for nearly 30 years, continue to be endorsed by the American Cancer Society, Society of Breast Imaging, American College of Radiology and Susan G. Komen for the Cure. • Yearly mammogram from age 40 to 80. • Breast self-exam each month for women over age 20. • A yearly clinical exam by a health care provider. whaT are The guidelines recenTly recommended By uspsTf and which organiZaTions supporT These guidelines? The guidelines issued from the USPSTF, which have been generally accepted by the American Academy of Family Physicians, recommend the following: • Mammogram once every two years after age 50 and up to age 74. • Discontinuation of monthly self-breast check. The task force states in its guidelines that it “encourages individualized, informed decision-making about when to start mammography.” It goes on to note that the recommendation to not screen between the ages of 40 and 50 does not apply to women with symptoms or who are at higher risk for breast cancer because of family or personal history. whaT is The difference BeTween screening and diagnosTic mammography? In general, a screening mammogram is performed on asymptomatic women and consists of four views of the breasts. A diagnostic mammogram is done only when a patient presents with a lump, pain, has had an abnormal screening mammogram or previous cancer. In these cases, a more customized view of the breast can provide better information to the physician. It’s important that women report any changes in their breasts or history as this could determine which is the best test for them. The bottom line is that women need to be aware of their breast health, their risks and talk with their physician about what test is best for them. About one-third of all American women do not receive regular screening mammograms. The concern is that the confusion by the USPSTF will result in more women not being screened, and that many more lives will be lost to breast cancer. The failure of age-appropriate women to undergo mammography costs lives.
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