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" When new guidelines were issued in 2009 by the U.S. Preventive Services Task Force (USPSTF), it sparked a huge controversy. The group says average-risk women shouldn&amp;#039;t start getting mammograms until age 50. But other groups, including the American Cancer Society, advise starting at 40. Two leading experts weigh in:   &amp;quot;Annual mammograms starting at 40 are a must.&amp;quot;   I strongly disagree with the USPSTF guidelines, because 95% of breast cancers occur in women who don&amp;#039;t have any known risk factors. It&amp;#039;s true that breast cancer becomes more common with age, but there starts to be an uptick in cases starting when women are in their 40s. In fact, 23% of breast cancer diagnoses are made between age 45 and 54.   Waiting until 50 is especially dangerous for women of color, because young African-Americans are significantly more likely to die from breast cancer than young Caucasian women.   There&amp;#039;s proof that starting screening at age 40 saves lives; it&amp;#039;s just a question of how much money we want to spend as a nation for screening versus how many lives are saved. While ignoring the cost savings of catching cancer early, the USPSTF calculated that we&amp;#039;d have to spend $100,000 to screen women in their 40s with mammograms to identify one woman&amp;#039;s breast cancer and perhaps save her life. Personally, I consider that money well spent. -Victoria Seewaldt, MD   &amp;quot;Most women can wait until they are 50.&amp;quot;   Routinely screening average-risk women in their 40s doesn&amp;#039;t make sense. No other country does that, and survival rates in the U.S. aren&amp;#039;t any higher.   Breast cancer in women under 50 isn&amp;#039;t as common as it is in postmenopausal women. When young women do get breast cancer it tends to be a more aggressive type, but it doesn&amp;#039;t show up well on a mammogram. Women in their 40s have dense breasts, and dense tissue looks white on a mammogram\u2014as do cancerous tumors. So trying to spot cancer is a little like looking for a polar bear in a snowstorm. As you get closer to menopause (usually around age 51), breast tissue turns to fat, which appears gray on a mammogram.   Because it&amp;#039;s so hard to interpret a younger woman&amp;#039;s mammogram, screening all women in their 40s leads to a lot of false positives. That&amp;#039;s stressful and it leads to unnecessary procedures (including biopsies).   The best thing young women can do: See your doctor yearly for a clinical (manual) exam. -Susan Love, MD   What You Can Do   \u2022 Ask your doctor when she recommends starting screening and why. \u2022 If you have a family history of breast cancer or other factors that raise your risk, don&amp;#039;t delay getting a mammogram past 40. In fact, you&amp;#039;ll probably want to start earlier (talk to your doctor). \u2022 If you&amp;#039;re African-American, start screening at 40 (or earlier; ask your doc). \u2022 If you&amp;#039;re high-risk (for example, you carry a BRCA mutation), err on the earlier side and ask your doc about getting an MRI or ultrasound in addition to mammograms. \u2022 Regardless of when you get mammograms, see your gynecologist yearly for a checkup that includes a clinical breast exam. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.womansday.com/health-fitness/womens-health/a5910/the-great-mammogram-debate-123829/>