Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Your doctor can clear up confusion on when to get breast screening

Trying to decide when to start and how often to have a routine mammogram can make your head spin. It used to be easy: starting at 40 have an annual mammogram. End of discussion.

Now, the major medical groups we have long relied on to tell women what to do about breast cancer screening aren't in complete agreement when it comes to women of average risk — that's the majority of us who have never had breast cancer and who don't have a mother, sister or child who had the disease. High-risk women have their own set of guidelines, which includes annual mammograms and breast MRI beginning as early as age 25 for some.

The major medical groups that issue general breast screening recommendations include the U.S. Preventive Services Task Force, the American Cancer Society, the American College of Obstetricians and Gynecologists and the American College of Radiology. (There are more groups, and you can see all their recommendations at the Centers for Disease Control and Prevention website:

Some of the highlights:

The Preventive Services Task Force recommends screening every other year starting at age 50. If a woman wants to start earlier, between ages 40 and 49, the task force says the option should be available — but only every other year, like the older group.

The American Cancer Society recommends annual screening for women starting at age 45, but if women want to begin earlier, at age 40 to 44, the option should be available. At age 55 and older the ACS says screening every other year is sufficient, but if a woman wants annual screening after age 55, the option should be available.

The American College of Obstetricians and Gynecologists and the American College of Radiology recommend annual screening beginning at age 40. ACOG also recommends an annual clinical breast exam through age 74.

Got that? And we haven't even addressed what the American Academy of Family Physicians and the American College of Physicians recommend. Nor have we covered the recommendations for women older than age 75.

"I see women every day who complain about the confusion around when to begin and how often to have screening mammograms," said Dr. Bethany Niell, a diagnostic radiologist in the Department of Diagnostic Imaging and Interventional Radiology at Moffitt Cancer Center. "My fear is that women will stop getting mammograms altogether because of the confusion. Screening every year starting at age 40 saves more lives."

Niell cited research which found that screening annually starting at age 40 saves an additional 65,000 lives each year, compared to starting screening at age 50. She also worries that the changes in screening recommendations may affect insurance coverage of mammograms.

"If these professional organizations disagree, it could affect access to this lifesaving intervention," Niell said. "Coverage under the Affordable Care Act is linked to the U.S. Preventive Services Task Force recommendation. So, if women age 50 to 74 want annual screening, they may not be guaranteed coverage."

The one point that most groups and physicians agree on is that women need to speak with their physicians to determine when they should start and how often to have mammograms.

"I agree that it can be confusing for patients," said Dr. Laura Arline, a primary care specialist in the BayCare Medical Group. "But, when you have that discussion and lay out all the guidelines and the risks and the benefits, women have been really good about knowing what they want to do."

Arline, who as a primary care doctor refers patients for health screenings such as mammograms, takes into consideration the woman's age, current health status, her family history of breast and other cancers, and her comfort level with each set of recommendations.

"Some women are okay with waiting until they're 50 to start screening. Others aren't," Arline said. "I lay out the information and she makes a choice with my input. It's our job as primary care providers to help patients figure out the best decision for them. It's an important discussion to have."

Your doctor can clear up confusion on when to get breast screening 09/29/16 [Last modified: Thursday, September 29, 2016 5:32pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. 'Empire' star Grace Byers keynotes USF Women in Leadership & Philanthropy luncheon

    Human Interest


    TAMPA — The first University of South Florida graduate to address the USF's Women in Leadership & Philanthropy supporters, Grace Gealey Byers, class of 2006, centered her speech on her first name, turning it into a verb to share life lessons.

    Grace Byers, University of South Florida Class of 2006, stars on the Fox television show Empire. She delivered the keynote at the USF Women in Leadership and Philanthropy luncheon Friday. Photo by Amy Scherzer
  2. Southeast Seminole Heights holds candlelight vigil for victims' families and each other


    TAMPA — They came together in solidarity in Southeast Seminole Heights, to sustain three families in their grief and to confront fear, at a candlelight vigil held Sunday night in the central Tampa neighborhood.

    A peaceful march that began on east New Orleans Avenue was held during the candlelight vigil for the three victims who were killed in the recent shootings in the Seminole Heights neighborhood in Tampa on Sunday, October 22, 2017.
  3. It's not just Puerto Rico: FEMA bogs down in Florida, Texas too

    HOUSTON — Outside Rachel Roberts' house, a skeleton sits on a chair next to the driveway, a skeleton child on its lap, an empty cup in its hand and a sign at its feet that reads "Waiting on FEMA."

    Ernestino Leon sits among the debris removed from his family’s flood-damaged Bonita Springs home on Oct. 11. He has waited five weeks for FEMA to provide $10,000 to repair the home.
  4. McConnell says he's awaiting Trump guidance on health care

    STERLING, Va. — Senate Majority Leader Mitch McConnell said Sunday he's willing to bring bipartisan health care legislation to the floor if President Donald Trump makes clear he supports it.

    Senate Majority Leader Mitch McConnell says he’s “not certain yet” on what Trump wants.
  5. Tampa's Lance McCullers shows killer instinct in pitching Astros to World Series


    HOUSTON — It felt like the beginning on Saturday night at Minute Maid Park, the arrival of a new force on the World Series stage. The Astros are back, for the first time in a dozen years, and they want to stay a while.

    Houston Astros starting pitcher Lance McCullers (43) throwing in the fifth inning of the game between the Houston Astros and the Tampa Bay Rays in Tropicana Field in St. Petersburg, Fla. on Sunday, July 12, 2015.