Risk helps determine when to have regular mammograms

October is Breast Cancer Awareness month, which offers a chance to remind people about the importance of early detection.

October is Breast Cancer Awareness month, which offers a chance to remind people about the importance of early detection.

The best tool for that is a mammogram. However, some women might not know when they should start getting them done.

The debate has been simmering for decades on when is the appropriate time to start getting mammograms.

The latest guidelines from the U.S. Preventive Services Task Force say "average-risk" women should begin at age 50, and test every other year.

Oregon Health & Science University (OHSU) Professor Dr. Heidi Nelson led the review that came to that recommendation.

“The trials and scientific evidence show benefit really starting at 50," said Dr. Nelson. “Quite honestly, most women in their 40s who have biopsies, don't have cancer.”

On the other end of OHSU’s campus, Dr. Karen Oh, the Diagnostic Radiology Professor and Director of Women's Imaging, has some different advice for patients. She is one of many specialists who believe earlier screenings are best.

“I wish that everybody would come in at 40,” said Dr. Oh. “If you want to save the most lives, improve the mortality the most, you would screen annually from 40 to 84.”

Adding to the conflicting opinions, the American Cancer Society now recommends annual screenings at 45.

If mammograms save lives - why isn't every doctor, every medical group on the same page?

It all comes down to balancing the benefits and harms. Dr. Oh mentions the problems of false positives.

“You get called back, but you don't have cancer. Or biopsies that you don't need or anxiety that you don't necessarily want to have,” said Dr. Oh.

That's why doctors tell patients that there is no perfect answer to the mammogram question.

About 80 percent of women with breast cancer have no family history and scientists don't know what causes it.

Until they can figure that out, there will be no "one-size fits all" recommendation. That’s why you should talk to your doctor about what's best for you.

“We need you to be a part of that decision to make sure your values are brought into play, to make sure no harms are done unnecessarily. It's a close call,” said Dr. Nelson.

If you do have a family history of breast cancer, your doctor will likely recommend even earlier mammograms. In some cases, that means screenings as early as your mid-20s.

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