Screening mammography guidelines have been confusing and conflicting since about 2009 when the US Preventive Services Task Force (USPSTF) made their evidence based guidelines of every other year starting at age 50 for average risk women. At the time, this was a sharp difference between the American College of Obstetricians and Gynecologists (ACOG) and the American Cancer Society (ACS) of yearly screening, starting at age 40. In the subsequent 8 years, the USPSTF has tried to make it less confusing for women by inserting language about consulting with their practitioners regarding screening mammogram starting at age 40 and every 1-2 years. But now, ACOG has revised their guidelines for average risk woman as of summer 2017:
· Women should be offered screening mammography beginning at age 40. If they don’t start in their 40s, they should do so at age 50 and this decision should include a discussion on the potential benefits and harms of screening.
· Screening should be every 1 or 2 years depending on patient preference
· Screening for women aged 55 and older is “reasonable”.
· Screening should occur until at least age 75 and after this age, decisions regarding ceasing screening should involve a discussion about her current health and life expectancy
· Clinical breast exams should be offered to women ages 25-39 every 1 to 3 years and annually, offered to women ages 40 and older.
These guidelines are now more in alignment with the USPSTF but still different than the ACS which is every year ages 45-54 and then annually, for average risk women.
Reference: ACOG Practice Bulletin #179. Breast cancer risk assessment and screening in average-risk women. Obstet Gynecol 2017 July; 130:241
