Do I need a mammogram?
There are differences of opinion in the medical community about the value of mammography among women under the age of 50, as shown in Table 1. Some people feel that even if only a few deaths are preventable, the time spent, anxiety, additional testing and well worth the discomfort.
Others feel that it does not apply to so few deaths preventable by early detection and the risk of having a mammogram than profits. Still others felt that the benefits and risks are shared enough so that women must weigh the benefits and potential risks and make a personal decision.
There are also different opinions in the medical community over the value of mammograms for women over the age of 70. Some people think that women should continue to have mammograms if the woman is in good health and has no serious illness or chronic. Others may think this is not worth it to the extent that early detection will induce an increase in surgical treatments of small invasive cancers and in situ (see issue 17) with a low expectation of having an impact on mortality breast cancer because older women have a shorter life expectancy and a higher risk of dying from a heart attack or a stroke than younger women. Others believe that the benefits and risks are balanced enough for an elderly woman should weigh the risks and potential benefits and take a personal decision.
Most would agree that women following must continue to have regular mammograms:
- Those who have already had breast cancer at about age whatsoever
- Women with a family history of breast cancer in the mother, a sister, a daughter.
- Women from 50 to 69 years.
Recommendations by organizations concerning mammography screening among women under the age of 50
Recommend
Do not recommend
College of Medicine
American Society of Cancer
International Agency for Research on Cancer
American College of Obstetrics and Gynecology
American Academy of Family Medicine
American College of Radiology
Canadian Task Force on the regular reviews of health
National Cancer Institute
References:
Mettlin C, Smart CR. Breast cancer detection guidelines for women aged 40 to 49 years: rationale for the American Cancer Society reaffirmation of recommendations. CA Cancer J Clin 1994; 44:248-255.
American College Radiology. Policy Statement: Guidelines for Mammography. Reston, VA: American College of Radiology, 1982.
Eddy DM (ed). Common screening tests. Philadelphia, American College of Physicians, 1991.
US Preventive Services Task Force. Guide to clinical preventive services. (2 nd ed.) Baltimore: Williams & Wilkins, 1996.
Canadian Task Force on the Periodic Health Examination. The periodic health examination. 2. 1985 update. Can Med Assoc J 1986; 134:724-727.
