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Breast cancer guidelines change

Black women must be cautious

OW Staff Writer | 10/29/2015, midnight
The American Cancer Society (ACS) recently published a new breast cancer screening guideline for women at average risk for developing ...

The American Cancer Society (ACS) recently published a new breast cancer screening guideline for women at average risk for developing breast cancer in the Journal of the American Medical Association (JAMA).

The biggest change to the guideline is that the ACS, now recommends that women at average risk for breast cancer start annual screening with mammograms at age 45, instead of at the previous age of 40. Now, women ages 40 to 44, can choose to begin getting mammograms yearly, if they prefer.

The ACS made this change because it said the evidence shows that the risk of cancer is lower for women ages 40-44 and the risk of harm from screenings (biopsies for false-positive findings, and over diagnosis) is somewhat higher. However, because the evidence shows some benefit from screening with mammography for women between 40 and 44 years, the guideline committee concluded that women in this age group should have the opportunity to begin screening based on their preferences and consideration of the tradeoffs. That balance of benefits-to-risks becomes more favorable at age 45, so annual screening is recommended starting at this age.

In addition, the new guideline says that women should transition to screening every two years starting at age 55, but can also choose to continue screening earlier and annually.

The ACS is also no longer recommending a clinical breast exam (CBE) as a screening method for women in the United States. That is because with the advancement of mammograms, the few studies that exist suggest that CBE contributes very little to early breast cancer detection in settings where mammography screening is available and awareness is high.

A CBE is a physical exam done by a healthcare provider as part of your regular medical check-up.

During a CBE, your provider should carefully feel your breasts and underarm for any changes or abnormalities (such as a lump). He/she should visually check your breasts while you are sitting up and physically examine your breasts while you are lying down.

If a CBE is not offered at your check-up and you would like one, ask your provider to perform one (or refer you to someone who can).

The ACE is also no longer recommending a breast self-exam as an option for women of any age. Again, the organization points out that evidence does not show that regular breast self-exams help reduce deaths from breast cancer. However, it is very important for women to be aware of how their breasts normally look and feel and to report any changes to a healthcare provider right away. This is especially important if a woman notices a breast change at some point in between her regular mammograms.

What is important to remember about the new guideline is that it targets women at average risk for breast cancer.

Only a small percentage of women are considered to be at very high risk for breast cancer.

For example, only about 5 to 10 percent of breast cancers in women are caused by inherited gene mutations. The best way to determine if you are at average or high risk for breast cancer is to talk with your healthcare provider about your family history and your personal medical history.