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Women In Their 40s Still Getting Mammograms

May 20, 2013
Written by: , Filed in: Breast Imaging
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When it comes to mammograms, U.S. women apparently prefer the advice of the American Cancer Society to that of the U.S. Preventive Services Task Force.

In 2009, the task force changed its recommendations on breast cancer screening, suggesting that women should begin routine mammography at age 50 instead of 40. Women in their 40s, the task force said, should consult their doctors about whether mammography is appropriate for their particular circumstances.

Other organizations and individuals in the breast cancer field disagreed, many of them vehemently. The cancer society continued recommending that mammograms start at 40.

A new Johns Hopkins study, published online last week in the Journal of General Internal Medicinefinds that the task force’s switch had little effect. Nationwide data from Behavioral Risk Factor Surveillance System surveys indicated that in 2006 and 2008, 53 percent of women in their 40s reported having a mammogram in the previous year. In 2010, after the task force’s new recommendations had been published. the percentage was 52—hardly a significant difference.

Lauren D. Block, MD, lead author of the study, said, “Patients—and likely their providers—appear hesitant to change their behavior, even in light of evidence that routine screening in younger women carries substantial risk of false positives and unnecessary further imaging and biopsies.”

Dr. Block continued:

Women have been bombarded with the message ‘mammograms save lives,’ so they want them no matter what.

Dr. Block is a clinical fellow in general internal medicine at the Johns Hopkins University School of Medicine in Baltimore. She was quoted in a Johns Hopkins news release.

Research published online last month in Cancer told the same story, actually finding a slight (although not statistically significant) increase in mammogram rates for women in their 40s.

Public and private insurance plans generally continue to cover routine mammograms for women in their 40s, which probably contributes to the continued high rate of screening, Dr. Block said. Many of her own 40-something patients, she said, want screening no matter what the pros and cons may be.

“Breast cancer gets so much attention in the media and in society in general, despite cardiovascular disease being by far the number one killer in women,” she said. “Everyone wants to feel as though they are preventing breast cancer. You hear one anecdotal story about someone in their 40s who found breast cancer during a mammogram and did really well with treatment, and that’s enough to fly in the face of any other facts that are out there.

“Women want the test.”

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The former chief executive officer of the Tuesday Morning store chain has filed a discrimination lawsuit saying that her firing was related to her being diagnosed with breast cancer. For details, see our Facebook page.

Related seminar: New Horizons in Breast Imaging

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