Early detection is essential when it comes to breast cancer (1
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The U.S. Preventive Services Task Force (USPSTF) released a draft recommendation suggesting that women get screened for breast cancer starting at age 40.
Previously the USPSTF had recommended that women between the ages of 40 and 50 discuss with their clinician whether or not they should start regular screenings based on their risk factors. At age 50 all women were recommended to start regular screenings.
They have also stated there is a need for further research to best address the health disparities among Black, Hispanic, Latina, Asian, Pacific Islander, Native American, and Alaska Native women, regarding screening and treatment.
Additionally, the USPSTF has called for studies to learn how screening with breast ultrasound or MRI could help women with dense breasts detect cancer earlier.
Why Screening for Breast Cancer at a Younger Age Is Beneficial
When women should start undergoing regular mammograms has been debated by experts for years. Breast cancer risk starts to increase after age 40.The American College of Obstetricians and Gynecologists has already recommended regular mammograms for women at age 40.
The American Cancer Society recommends women have the option to start yearly screenings between ages 40 to 44 and have annual mammograms starting at age 45.
But there can be issues if people undergo screening too early. The concern about screening younger women is that there are potential adverse effects such as the need for biopsy and causing patients to worry, Dr. Pamela Berens, an OBGYN with McGovern Medical School at UTHealth in Houston explained.
“I am pleased with the change in the draft recommendations by the USPSTF to begin mammography for average-risk women at age 40,” said Berens, an obstetrician and gynecologist with McGovern Medical School at UTHealth in Houston.
Risk related to radiation exposure with regular screening is minimal and should not discourage screening, experts say.
Women should be counseled about the benefits of earlier screening and the possibility that they may need additional follow-up imaging and/or biopsy to evaluate mammography findings.
“This reversal from the task force’s previous recommendation for women to start mammograms at age 50 may on the surface seem confusing, but it boils down to saving more lives,” said Dr. Irene M. Kang, medical director of women’s health medical oncology at City of Hope Orange County and a medical oncologist specializing in breast cancer at City of Hope Orange County Lennar Foundation Cancer Center in Irvine, California.
Earlier screening aligns with the National Comprehensive Cancer Network’s guidelines that women should first undergo a breast cancer risk assessment at age 25, with annual mammograms starting at age 40 if they are considered at average risk of developing breast cancer, Kang said.
“I have always recommended starting at age 40 for my patients as well,” Dr. Jill Purdie, board-certified obstetrician and gynecologist and medical director based at Northside Women’s Specialists in Georgia, told Healthline. “I do feel that we can identify more cancers in early stages when the screening begins at a younger age. Identifying breast cancer at an earlier stage does improve outcomes for women.”
Dr. Katharine Lampen-Sachar, section chief of breast imaging at Miami Cancer Institute, part of Baptist Health South Florida, also said starting at age 40 is smart, but suggests that some at-risk women could start talking to their physicians at age 30 about whether or not they should start regular screenings.
“There are populations of women that benefit from starting even earlier than age 40, and those would be women who are at a higher risk of developing breast cancer,” Lampen-Sachar said. “What’s really important is that women around age 30 start to have discussions with their doctors to learn if they’re at high risk of developing breast cancer. If they’re high risk, they would probably benefit from starting earlier.”
Breast Cancer Risk Varies for Different Demographic Groups
Experts say more needs to be done to ensure everyone has access to mammograms and regular cancer screenings.
“We need to provide easy access to quality mammography screening and evaluation across racially and socioeconomically diverse groups,” said Berens. “We also need to learn more about genetic variations in breast cancer and other risk factors that impact breast cancer (such as reproductive history and hormonal use).”
Economics, education, cultural differences, genetic variances, and access to care all play a role in diagnoses and outcomes. Individuals who are not up to date with cancer screening are disproportionately found among racial and ethnic minorities and other underserved populations. Quality of care or access to care for these populations isn’t always the same as it is for others, especially after diagnosis, Kang said.
“The key takeaway is that cancer isn’t equal and screening and treatment is never a one-size-fits-all approach,” said Kang. “Cancer is a highly personal disease that differs from individual to individual – with age, race, and family history being just a few of the factors that need to be taken into account. In cancer care, experts matter. The variation in cancer risk among ethnicities and races highlights important health disparities among ethnic groups in the United States.”
For example, while Black women have a 4% lower incidence rate of breast cancerTrusted Source than white women, they have a 40% higher breast cancer death rate. Studies show that Black women are more likely to be diagnosed with breast cancer when the disease is in an advanced state compared to white women.
Takeaway
The U.S. Preventive Services Task Force recently released a draft recommendation that calls for women to start the screening process at age 40.
There is a need for more research to address the health disparities across screening and treatment among different ethnic groups.
Experts agree that screening at age 40 is beneficial. It’s also suggested that women around age 30 start talking to their doctors about breast cancer risks and educating themselves.
