Breast Screening Guidelines Position Statement from Dr. Nichols

Following the recent publication of the US Preventative Services Task Force guidelines on 11/16/2009, there has been a flurry of publicity about the need for mammograms and breast self examination in the 40-49 year age-group. As a member of the local breast cancer tumor board, I wanted to comment on the local viewpoint here in Tacoma and Pierce County. Locally we have unanimously agreed with the position of many prominent national and regional organizations (including the National Cancer Institute, the American Cancer Society, and the Seattle Cancer Care Alliance) to suggest that women continue with existing breast imaging and exam guidelines listed below. I have personally have treated many patients in the 40-49 year age-group who have had life threatening breast cancers detected on mammogram or self-exam. Also, in discussion with my radiology colleagues it is noteworthy to point out that greater than 70 cancers have been mammographically detected in members of this age group so far this year.

I would like to make this information available to patients that may be considering mammograms and self exams the existing widely recognized guidelines are:

• Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
• Clinical breast exam (CBE) should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for woman 40 and over.
• Women should know how their breasts normally feel and report any breast change promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s.
• Woman at high risk (greater than 20 percent lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15 percent to 20 percent lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15 percent.


For additional information please refer to:

The Carol Milgard Breast Center
4525 S 19th St
Tacoma, WA 98405-1106
253-759-2622

www.carolmilgardbreastcenter.org

The American Society of Breast Surgeons
www.breastsurgeons.org