Breast cancer screenings should begin at 40 — not 50: health alert

Women with an average risk of breast cancer should get screened every other year starting at age 40 — 10 years earlier than previously recommended, according to draft guidance issued Tuesday by the US Preventive Services Task Force.

“New and more inclusive science about breast cancer in people younger than 50 has enabled us to expand our prior recommendation and encourage all women to get screened every other year starting at age 40,” Dr. Carol Mangione, immediate past chair of the task force, said in a statement. “This new recommendation will help save lives and prevent more women from dying due to breast cancer.”

The panel of national experts recommended in 2016 that women in their 40s make their own decision about screenings based on their health history and preferences, with 50 long seen as the age to start getting mammograms.

The panel believes this new proposed change could result in 19% more lives saved.

Breast cancer is the second most commonly diagnosed cancer (behind skin cancer) and the second leading cause of cancer death in US women, according to the American Cancer Society.

The organization estimates that nearly 298,000 new cases of invasive breast cancer will be diagnosed in women this year, while some 43,700 women will die of breast cancer.

Other organizations, including the American College of Radiology and the American Cancer Society, already suggest women begin getting annual mammograms at 40 and 45, respectively.

The new task force recommendations come after a recent study found that black women should be screened for breast cancer starting at 42 instead of 50.

The task force acknowledged the racial disparities in breast cancer diagnoses, noting that black women often develop breast cancer younger and are 40% more likely to die of the disease than white women.

“Ensuring black women start screening at age 40 is an important first step, yet it is not enough to improve the health inequities we face related to breast cancer,” task force vice chair Dr. Wanda Nicholson said in a statement.

The panel said more research is needed to know how best to address the health disparities faced by black, Hispanic, Latina, Asian, Native American, and Alaska Native women, particularly how to ensure followup after screening.

Additional research would also benefit women with dense breasts, for whom mammograms may not work as well because the tests are less sensitive and more likely to miss cancer.

“We know that women with dense breasts are at higher risk of breast cancer and, unfortunately, mammograms do not work as well for them,” task force member Dr. John Wong said in a statement.

Dense breasts are composed of more glandular and fibrous tissue and less fatty breast tissue. Women with dense breasts have a higher risk of breast cancer than women with fatty breasts, according to the National Cancer Institute.

The density of breasts can change over time. People younger, pregnant or breastfeeding; on hormone replacement therapy; or with a lower body weight are more likely to have dense breasts.

One study found that 43% of women 40 to 74 years of age have extremely dense breasts.

“What we don’t know yet, and what we are urgently calling for more research on, is whether and how additional screening for women with dense breasts might be helpful, including through ultrasound, breast MRIs, or something else,” Wong said.

Doctors recommend all women perform visual and physical breast self-exams at least once a month.

The task force suggests that anyone concerned with their breast health should contact their doctor.