New mammography guidelines from American Cancer Society prompt debate

UMMS radiologist recommends first breast screening at 40 years, followed by annual exams

By Megan Bard and Bryan Goodchild

UMass Medical School Communications

October 22, 2015

The American Cancer Society’s new recommendation to delay first mammograms to age 45 means yet another differing opinion for women trying to decide when and how often to have breast cancer screenings.

UMass Medical School radiologist Gopal R. Vijayaraghavan, MD, MPH, supports the American College of Radiology’s guidelines to start mammograms at age 40 and continue them annually.

“If I were a woman in my 40s, 50s or 60s today I would be very confused. Given that different societies have given us different recommendations, it becomes very difficult for a woman to choose which is the best option,” said Dr. Vijayaraghavan, clinical associate professor of radiology.

He said evidence and literature shows that during the past nearly three decades of mammography use, there has been a drop in mortality rates of nearly 30 percent. For this reason, Vijayaraghavan will continue to recommend annual mammograms in women 40 years and older until he hears compelling evidence to the contrary, despite the latest recommendations from the American Cancer Society.

On Oct. 20, the cancer society changed its longstanding guidelines that women should start receiving annual mammograms and clinical exams upon turning 40 years old. It now recommends that women with an average risk of breast cancer have their first mammogram at 45 years and do so annually until age 54. Thereafter, women should receive such exams every other year for as long as they remain healthy.

This differs from the U.S. Preventative Services Task Force recommendation for biennial screening mammography for women 50-74 years of age and that the decision to start at a younger age should be the patient’s.

Vijayaraghavan said he fears some women will delay or forgo having mammograms and that some insurance companies may decide not to pay for annual mammograms based on differing opinions from different societies.

“One fact is very clear: mammography saves lives. The question really is how best or how optimally do we utilize this tool and that is where I think the societies have differed,” said Vijayaraghavan.

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