When Should You Have A Mammogram? New Guidelines From The American Cancer Society

For the first time since 2003, the American Cancer Society has changed its recommendations on routine mammograms in women.

They say women of average risk can start screening at age 45, a bump of five years from the old recommendation of age 40. And compared to other groups, this 45-year-old start age seems a compromise between those who say start at 40 and those who say start at 50.

Why the change by the ACS? Their analysis of more than 15,000 women with breast cancer shows the best benefit with least risk points the needle at age 45 as the best age to start.
And when you refer to benefit versus risk, you're talking about the most accurate diagnosis, fewer false positive exams, and the best likelihood of having successful treatment.

Here's a basic summary of the new recommendations:

First screening mammogram for women of average risk at age 45.

Annual mammograms until age 55, at which point transitioning to every other year may be acceptable.

Continue screening women until you estimate a life expectancy of at least 10 years; meaning, a healthy 80 year old may certainly benefit from having a screening done, while a 65 year old with terminal heart disease, diabetes, and a host of other medical conditions may not.

As for having a clinical breast exam in your doctor's office: the ACS says forget them. The yield is poor, and time might be better spent on discussion of screening, health lifestyle, etc. etc.

I'm still a big advocate of self exam, as it seems a monthly self check in the shower, for example, let's a woman get to know her breast tissue, and any changes that might be taking place that warrant a follow up.

Now having made these recommendations, the ACS emphasizes that one size does not fit all. These are simply guidelines that don't work for all women. In an office setting, you and I need to spend the time discussing the risks and the benefits of screening mammograms based on your lifestyle, family history, personal history etc. The days of any doctor saying: "you MUST do this!" is long gone. But we do need to take the time to talk about things—give and take is a good way to decide how you are most comfortable with your medical care.

Things are certainly changing, and will continue to change at a rapid pace. For example, do all women with a diagnosis of certain types of breast cancer always need treatment? Or skip the surgery, do the chemo; or vice-versa? Is watchful waiting ever okay? These are questions we wouldn't have even considered 5-10 years ago. But we are now talking about them now.

Bottom line: times are changing, and the changes are coming at warp speed. Don't be afraid to ask questions! It's your body, and our job is to help guide you in any of the ways we have in our little black bag of medical know-how.

Dr. Dave Hnida is CBS4's Medical Editor. He blogs about the latest studies and trends in the health world. Read his latest blog entries, check out his bio or follow him on Twitter @drdavehnida