Patients should decide when to get mammograms: Canadian health experts

New guidelines from the Canadian Task Force on Preventive Health Care are empowering women to take charge of their health when it comes to breast cancer screening.

The new recommendations update guidelines first published in 2011. Routine screening still isn’t recommended for women between the ages of 40 and 49 with what experts call a normal risk of breast cancer, while health professionals say normal-risk women aged 50 to 74 should have a mammogram every two to three years.


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However, the panel now says the final decision on whether to be screened should fall to the patient as long as that patient understands the risks.

“From women 40 to 49 years of age, we know the harms of screening — including things like false positives and overdiagnosis — are increased and the benefits of breast cancer screenings — including reduction in breast cancer mortality — tend to be a little bit less,” said Dr. Donna Reynolds, a member of the task force.

Research has found that for women aged 40 to 49, screening of 1,000 women over seven years resulted in 294 false-positive results and prevented less than one cancer death.

Still, Reynolds said any life saved is significant, which is why patients should be left ultimately decide what is best for them.

“We don’t want to say that screening does not have any benefit, even though the harms are more significant in this age group,” Reynolds said. “That’s why we’ve moved to a shared decision-making model.”

“If we bring the information to you, and you bring in your values to help with your preferences — no matter what age — that is what is right for you.”

The new guidelines also continue to recommend against breast cancer screening normal risk women using MRI, tomosynthesis or ultrasonography, based on a lack of evidence.

Women with an average risk of developing breast cancer are described as having no previous breast cancer, no history of the disease in a first-degree relative like a mother or sister, no known BRCA genetic mutation and no previous exposure to therapeutic radiation of the chest wall.

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