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New breast screening recommendations spark debate

Experts offer advice on new breast screening recommedations
Posted at 5:44 PM, Apr 10, 2019
and last updated 2019-04-11 08:32:02-04

BUFFALO, NY — More confusion from the latest recommendations. The American College of Physicians (ACP) now saying women should start mammograms at the age of 50, then go every other year up to the age of 74, if they are at low risk. We spoke with local experts about best practices for breast screening guidelines.

The new recommendations are sparking debate because it contradicts previous recommendations – such as the American College of Radiology, which recommends starting at age 40 and every year after that.

Dr. Anna Chen, director of women’s imaging, Windsong Radiology, Amherst, maintains age 40-years old is the best.

“It's just a little disturbing that we keep getting this mixed message in terms of when patients should start mammograms,” explained Chen. “I just think it’s confusing.

But the ACP recommendations take risks and benefits into account, including annual screenings which create more false-positive results and could require unneeded biopsies.

Roswell Park's Breast Imaging area.

We spoke with Dr. Ermelinda Bonaccio,chair of Diagnostic Radiology at Roswell Park Comprehensive Cancer Center in Buffalo.

“I actually disagree with this final recommendation,” Bonaccio declared.

Dr. Bonaccio said yearly screening has lowered the risk of dying from breast cancer by 20 to 40-percent, and that’s significant.

“We feel that the benefit – the mortality benefit – the lowering of the risk of dying of breast cancer – far out ways these harms or risk and continue to recommend annually screening mammography beginning at the age of 40,” noted Bonaccio.

But if you are a woman with abnormal screening results – have a family history of cancer or carry a gene mutation – these recommendations don't apply.

American Cancer Society, WNY Chapter

The American Cancer Society recommends yearly mammograms starting at age 45 and one every other year starting at age 55.

“We want women to be informed of the benefit and the limitations of mammography, so yes, you're getting mixed information – perhaps in terms of what age to start/stop, but at very least at the age of 40 your informed decision making has to be there so that you can make the right decisions for your own health with your physician,” remarked JoAnna Jacob, executive director, American Cancer Society, WNY chapter. “Please, please, please – because of your body – be aware of the guidelines that we have – certainly take in any information that you can.”

As for the recommendation from the ACP regarding women over the age of 74 stopping screening, Dr. Chen is asked often by patients, ages 60 to 80, do they need to come every year.

“And I say absolutely – if we found something concerning on your mammogram that could be a cancer,” Chen noted.

We asked Roswell’s Dr. Bonaccio what her solid advice for women is.

“My bottom-line advice is still starting annual screen mammography starting at the age of 40 saves the most lives,” Bonaccio replied.