In shift, Cancer Society now advises fewer mammograms

Women should begin annual breast cancer screenings at age 45, according to mammogram guidelines released Tuesday from the American Cancer Society. That’s five years later than the society previously recommended.

The new recommendations have generated far less controversy than the 2009 guidelines from a federal task force that suggested women didn’t need routine mammograms until age 50. At the time, the American Cancer Society and other critics reacted angrily, charging that following the task force’s advice would lead to more women dying of breast cancer.

The new mammogram guidelines move the American Cancer Society closer to the recommendations it criticized six years ago. Though the society says women should get annual screenings from ages 45 to 54, it said women at 55 can transition to getting mammograms every other year because cancers then grow more slowly.

These are big changes for the American Cancer Society. As recently as 1992, the group recommended women get a “baseline” mammogram at ages 35 to 39.

The new guidelines reflect the growing recognition that mammograms can do harm, as well as good, said Richard Wender, chief cancer control officer at the American Cancer Society. Beyond “false positive” results — which can lead women to undergo additional tests and painful biopsies — mammograms can lead to “overdiagnosis,” causing women to be treated unnecessarily for slow-growing cancers that would have never become life-threatening.

“We’re moving to an era where people are recognizing the limitations of screening tests,” said physician Nancy Keating, who co-wrote an accompanying editorial in JAMA.