Beaufort News

Professional Opinion: Help -- these mammogram guidelines are confusing

Dr. Rochelle Ringer
Dr. Rochelle Ringer Submitted photo

This week, Dr. Rochelle Ringer, breast cancer surgeon at Hilton Head Hospital's Breast Health Center in Bluffton, discusses when a woman should get a mammogram.

Question: I keep hearing different guidelines for when a woman should get a mammogram. What are the generally accepted guidelines and is self-examination also still a good idea?

Answer: Get your mammogram at age 40, 45, 50? Get a mammogram every year, every other year? There is a lot of information out there with no clear guidelines. So what's a woman to do?

The American Cancer Society just changed their guidelines and is now recommending average risk women start getting mammograms at age 45.

The United States Preventative Services Task Force recommends that women start getting mammogram at age 50 and then every other year with selective women starting at age 40.

The American College of Radiology and Society of Breast Imaging recommend starting mammogram at age 40 and continue yearly. It's difficult for women to know what to do if the professionals can't agree.

Breast cancer is more common as women get older. The more likely a test is to find cancer, the more useful the test.

Unfortunately with any test (including mammogram), there are risks. Mammogram exposes a woman to radiation. Also, mammograms have false positives which mean that something is found and additional tests and possibly biopsies are needed for something that ends up being fine.

This causes a lot of anxiety and can be expensive. Unfortunately, breast cancer happens in younger women and mammogram has been shown to find cancers in women in their 40s that may not be diagnosed for years if they don't start getting a mammogram until age 45 or 50.

As physicians, we try to balance the risks and benefits of tests before we recommend them. I personally and the MUSC Breast Care Team recommend that women start getting mammogram at age 40 and then yearly.

As with anything, a full discussion with your physician about what's best for you is always a good idea.

If a woman has a family history of breast cancer or other risk factors for breast cancer, they may need to start mammogram earlier and may need additional screening. These women may want to see a breast surgeon to help decide the best imaging for them.

The recent American Cancer Society guidelines also recommends against women having a clinical breast exam (an exam done by your doctor). I disagree.

There are some breast cancers that are not easily seen on mammogram and may only be picked up by a physician. Physicians have training doing breast exams and may be able to notice things that patients have not noticed.

Should a woman do a self-breast exam? My answer is: it depends. I have met many women who have found their breast cancer by doing a self-exam.

I have also met many women who tell me that if they did a monthly self-breast exam, they would be in my office every month with another lump to check and stress out about it.

As long as women are getting mammograms and seeing their doctors for a clinical breast exam on a routine basis, I don't feel women have to do a self-breast exam. If a woman feels comfortable with their exam, then I think it can be a great addition to their care.

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