There is no one-size-fits-all answer for when to start getting mammograms

Woman receiving a mammogram (National Cancer Institute)

October is Breast Cancer Awareness Month. It's a chance to remind people about the importance of early detection.

The best tool for that is a mammogram. But if you're a woman in your 40s, chances are you're somewhat confused about mammograms. The debate has been simmering, sometimes boiling ... For decades.

The latest guidelines from the U.S. Preventive Services Task Force say "average-risk" women should begin at age 50- and test every other year.

“The trials and scientific evidence show benefit really starting at fifty," said Dr. Heidi Nelson

Dr. nelson, an Oregon health and sciences university professor, lead the review that resulted in that recommendation. Her work was featured in the New York Times

“Quite honestly, most women in their 40s who have biopsies don't have cancer,” said Dr. Nelson.

But take a walk across OHSU'S campus, and Dr. Karen Oh – the Diagnostic Radiology professor and director of Women's Imaging -- has some different advice for patients.

“I wish that everybody would come in at 40," said Dr. Oh.

Dr. Oh is one of many specialists who believe earlier screenings are best.

“If you want to save the most lives, improve the mortality the most, you would screen annually from 40 to 84," Dr. Oh. Said.

Adding to the conflicting opinions; the American Cancer Society now recommends annual screenings at 45.

So, if mammograms do save lives, then why isn't every doctor, every medical group on the same page? It all comes down to balancing the benefits and harms.

Dr. Oh says that false positives are one concern.

“So you get called back but you don't have cancer, or biopsies that you don't need or anxiety that you don't necessarily want to have,” said Dr. Oh.

That's why doctors tell patients that there is no perfect answer to the mammogram question.

About 80 percent of women with breast cancer have no family history, and scientists don't know what causes it. Until they can figure that out- there will be no "one-size fits all" recommendation, so talk to your doctor about what's best for you.

“We need you to be a part of that decision to make sure your values are brought into play, to make sure no harms are done unnecessarily,” said Dr. Nelson. “It's a close call."

If you do have a family history of breast cancer- your doctor will likely recommend even earlier mammograms.

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