The question of how often to get mammograms, and when to start getting them, has gotten a whole lot more complicated lately. As we've written about before, the official recommendation is now that women don't begin receiving mammograms until age fifty, and then only every two years (unless you have specific risk factors that lead your doctor to recommend earlier or extra screening). The US Preventative Services Task Force, the government arm that issues these recommendations, wrote in 2009 that routinely giving mammograms to women younger than 50 results in too much follow up testing and treatment that doesn't result fewer deaths, and only creates unnecessary stress and complications for the patients (and, though they don't say this, extra cost for whoever is footing the bill).
But many private doctors tell their patients to ignore those recommendations and continue getting a mammogram annually. I know that my OB-Gyn told me that, in her opinion anyway, the new recommendation of fewer mammograms is nothing but a move by the medical community to cut costs. So she tells her patients to get an initial mammogram in their late 30s. The attitude of doctors such as her seems to be, "Forget what's best for the population as a whole, I want my patients to be as protected as they can be."
That attitude seems to make sense, on an individual basis, unless you consider that the radiation used in mammograms may actually be a cause of breast cancer. Although the radiation used in mammography is considered "low dose" certainly in comparison to CT scans, a new report from the Breast Cancer Fund sums up the state of the research on mammography's potential dangers, and they're worth considering. There are certain subsets of women who may be especially vulnerable to the radiation in mammograms, including women with the BCRA mutation (how horribly unfair that the very genetic stroke of bad luck that makes them need more screening should also make them more vulnerable to it), and older women. According to the report: "Increased vulnerability has been found in women with BRCA mutations as well as in women with other relatively uncommon polymorphisms in genes known to be involved in various steps of DNA repair" and "the detrimental effects of mammography might also be heightened in older women, whose breast epithelial cells have gone through several decades of cell division. Cells derived from older women's breast tissue were more sensitive to the DNA-damaging effects of low-energy radiation, increasing the likelihood of later conversion to cancerous cells."
So, you might ask, what are you supposed to do with this unsettling information? Unfortunately, there's no clear answer, but for now we should just bring the possible risks of mammography into our conversations with our doctors when we're deciding on our individual screening schedules.
