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Response to the American Cancer Society Breast Screening Recommendations

January 15, 2016
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SOMERVILLE, NJ, January 15, 2016 -- The American Cancer Society and the US Preventive Services Task Force recently released new guidelines for breast screening. These guidelines include the recommendation that women at average risk for breast cancer can wait until age 45 to undergo their first mammogram and that at age 55 women can begin transitioning to getting their mammogram every other year instead of annually. The breast cancer multidisciplinary team at the Steeplechase Cancer Center at Robert Wood Johnson University Hospital Somerset met to discuss these new guidelines. The breast cancer team consists of radiologists, breast and reconstructive surgeons, medical and radiation oncologists, primary care physicians, registered nurses, mammography technicians, physical therapists, hospital administrators and certified wig and prosthetic fitters.

Along with the American College of Radiology, Society for Breast Imaging, American Congress of Obstetricians and Gynecologists and Radiological Society of New Jersey, we unanimously continue to recommend the following breast cancer screening guidelines for women:

  1. Annual clinical breast exam starting at 20 years of age.
  2. Annual mammography starting at 40 years of age. Women at high risk for breast cancer should talk to their physicians about getting screened at an earlier age.
  3. Annual mammograms should continue in elderly women. There is no age at which annual mammography should stop. This should be determined by the patient and her physician.

We recognize that any time new guidelines are announced it can be confusing to the members of our community. We are committed to providing our patients with the most current recommendations for prevention, early dedication and treatment. Our recommendations are based on our first-hand experiences of patient care in our community, analysis of peer reviewed research and our extensive training in this specific healthcare issue. Our recommendations are based on the following:

Mammograms Are An Effective Screening Tool
Mammography is a remarkably simple, effective, affordable, safe and widely available examination. It has been proven to save lives. Coupled with advances in breast cancer treatment, mammography screenings have helped significantly decrease mortality rates from breast cancer.
Now with the newest 3D technology, mammography has the potential to save even more lives. 3D mammography provides state-of-the-art, detailed imaging to help radiologists more accurately identify cancer at its earliest stages and better determine when a biopsy is necessary and when it is not.

Breast Cancer Has Been Increasing in Younger Women
According to a study in the Journal of the American Medical Association, the incidence of breast cancer has increased in 25 to 39-year-old women between 1976 and 2009. There are a variety of factors that may increase women’s risk for developing breast cancer. First menstrual periods are starting at younger ages which increase breast cancer risk. Women are more commonly using contraceptives and fertility treatments that contain hormones that increase their risk of breast cancer. Delaying childbirth until after age 30 or remaining childless also increases breast cancer risk.

Early Detection is Key
The goal of screening is to detect a cancer in its early stages, therefore saving lives. We fear that if women do not get their mammograms on an annual basis, cancers may be found at later stages requiring aggressive treatment, which can be a significant burden on the patient, their spouses/partners, their children and even their work.

Breast Cancer Knows No Age Limits
The risk of getting breast cancer increases as we get older. While the physician and patient may choose to forego mammography at a certain age or if there are significant medical problems, the clinical breast exam should continue.

Clinical Breast Exams Are Beneficial for All Ages
Clinical breast exams are an excellent opportunity for women of all ages to discuss their breast health with their physicians and patients. A quick physical examination can detect a growing lump and allow for that patient to get treatment more quickly. While a cure may not be an achievable goal in all patients, tumor growth and spread can usually be controlled. However, one can control of pain, improve comfort and decrease the risk of infection. We strongly recommend that clinical breast exams be performed on an annual basis.

Above all, we encourage women to talk to their physicians about their risk for breast cancer, how to perform a breast self-exam and when to begin mammography screenings.