WEDNESDAY, July 20 (HealthDay News) — The value of annual mammograms for women in their 40s — the topic of a lingering debate among health policy and advocacy groups — has drawn resounding support from the nation’s largest group of obstetricians/gynecologists.
On Wednesday, the American College of Obstetricians and Gynecologists (ACOG) issued new guidelines calling for mammograms to be done every year beginning at age 40. This is a departure from its previous recommendations, which advised mammograms every one to two years beginning at 40 and then annually beginning at age 50, based on the incidence of breast cancer in younger women and its typically more rapid progression, guidelines co-author Dr. Jennifer Griffin explained.
More than 207,000 American women were diagnosed with invasive breast cancer in 2010, according to ACOG, and nearly 40,000 died from it. Breast cancer is the second most common type of cancer among women in the United States after skin cancer. It may be detected by a mammogram while it is very small and before it grows big enough to become symptomatic.
A key factor in the ACOG recommendation is the shorter “sojourn time” — the time period in which a breast cancer can be detected by a mammogram while it is still very small and before it gets big enough to cause symptoms — among younger women. Women aged 40 to 49 have a sojourn time of 2 to 2.4 years, the guidelines said, while those ages 50 to 59 have a sojourn time of 2.5 to 3.7 years, and women 70 to 74 have a sojourn time of 4 – 4.1 years.
“In these younger patients, we have a smaller window because these cancers tend to grow faster, sooner,” said Dr. Lauren Cassell, chief of breast surgery at Lenox Hill Hospital in New York City. “There are plenty of patients who develop breast cancer between 40 and 50. The fear was we would miss these patients and see them at later stages.”
Some early, noninvasive breast cancers, known as ductal carcinoma in situ (DCIS), never progress to dangerous cases, Griffin acknowledged, and mammogram detection may provoke aggressive treatment that ultimately is unnecessary or harmful.
But, “there’s not a lot of consensus exactly how many cancers might regress . . . and no way of knowing which ones might regress or progress,” she said. “It’s true that some of these cancers we detect would not progress.”
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