One of the most respected and influential groups in the continuing breast-cancer screening debate said on Tuesday that women should begin mammograms later and have them less frequently than it had long advocated.
The American Cancer Society, which has for years taken the most aggressive approach to screening, issued new guidelines on Tuesday, recommending that women with an average risk of breast cancer start having mammograms at 45 and continue once a year until 54, then every other year for as long as they are healthy and expected to live another 10 years.
The organization also said it no longer recommended clinical breast exams, in which doctors or nurses feel for lumps, for women of any age who have had no symptoms of abnormality in the breasts.
Previously, the society recommended mammograms and clinical breast exams every year, starting at 40.

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The changes reflect increasing evidence that mammography is imperfect, that it is less useful in younger women, and that it has serious drawbacks, like false-positive results that lead to additional testing, including biopsies.
But the organization’s shift seems unlikely to settle the issue. Some other influential groups recommend earlier and more frequent screening than the cancer society now does, and some recommend less, leaving women and their doctors to sort through the conflicting messages and to figure out what makes the most sense for their circumstances.
In fact, although the new guidelines may seem to differ markedly from the old ones, the American Cancer Society carefully tempered its language to leave plenty of room for women’s preferences. Though it no longer recommends mammograms for women ages 40 to 44, it said those women should still “have the opportunity” to have the test if they choose to, and that women 55 and older should be able to keep having mammograms once a year.
This year, 231,840 new cases of invasive breast cancer and 40,290 deaths are expected in the United States.

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The new guidelines were published on Tuesday in the Journal of the American Medical Association, along with an editorial and an article on the benefits and risks of screening, which provided evidence for the guidelines. A separate article and editorial on the subject were also published in another journal, JAMA …Read More

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