Women Make Difficult Decisions Every Day...

But until recently, whether to get regular mammograms wasn't one of them.

Since the early 1980s, doctors have advocated annual breast-cancer screening mammograms for women starting at age 40. Women at higher risk because of family history or gene mutations usually start testing sooner.

In the fall of 2009, the United States Preventive Services Task Force—an independent panel of health experts—revised some of these longstanding guidelines. The new recommendations say that women with no special risk factors should start screening at age 50, not 40, and that mammograms should be done every two years rather than annually. However, there has been no new evidence to justify this recommendation for change in breast cancer screening guidelines.

"The new guidelines have created confusion for both women and doctors," says Richard Reitherman, M.D., medical director of the MemorialCare Breast Center at Saddleback Medical Center. "But we continue to strongly recommend annual mammograms beginning at age 40. This is in line with the recommendations of the American Cancer Society, the American College of Radiology, the American Society of Breast Disease and many other advocacy and physician groups."

Early Detection

Dr. Reitherman says there are good reasons why younger women should have regular screenings. "Up to 21 percent of breast cancers occur in women age 40 to 49, and they are more likely to be fast-growing. Mammography helps find tumors in the early stages, when they are easier to treat."

Mammograms are indeed one of the most important tools for the early detection of breast cancer. These low-dose X-rays can reveal cancerous growths long before a lump is large enough to be felt. Mammograms can even find microcalcifications—tiny deposits of calcium in the breast that are sometimes the first indication of cancer.

To ensure the safest, most accurate screening, the MemorialCare Breast Centers at Saddleback Medical Center in both Laguna Hills and San Clemente offer digital mammography, an advanced form of breast imaging. It is faster than traditional film mammography, exposes women to less radiation and limits the need for retakes. It also allows the radiologist to manipulate the image, magnifying details and increasing or decreasing contrast, or reversing black and white values. This improves the quality and interpretation of the test.

Studies have shown that digital mammography is significantly better than film mammography for screening women who are under age 50, pre- or perimenopausal, or have very dense breast tissue. Screening mammograms are still the best tool for detecting breast cancers at the earliest and most treatable stage.

Women are less likely to die of breast cancer today than they were 20 years ago. This is partially due to advances in therapies, but also to a wider use of mammography. "Screening mammograms remain the best method for detecting breast cancer at a curable stage," Dr. Reitherman says. "I encourage every woman to discuss mammography with her doctor, to weigh the risks and benefits in her own case, and then make the decision that is right for her."

Newly Announced Rules Expand Access To Mammography

The U.S. Departments of Treasury, Labor and Health and Human Services have jointly released regulations that address preventative health care requirements established by the recent health care reform legislation. The regulations require health plans to cover specified preventive screening. A provision in the new law specifies that women ages 40 and over will be able to get screening mammograms every one to two years at no cost.