Women should be receiving mammograms starting at age 40, instead of waiting until 50, according to new draft guidance from the U.S. Preventive Services Task Force. The recommendation comes amid rising breast cancer cases in younger women and persistently high mortality rates in Black women. An estimated 1 in 8 women will be diagnosed with breast cancer in their lifetime, according to the American Cancer Society. The draft guidance is open to public comment until June 6.
The new guidance applies to women who are at average risk, and don’t include those with a previous history of breast cancer or those that have inherited a genetic mutation that increases the risk of developing it, says Roni Caryn Rabin, health writer at the New York Times.
It also reinforces the advice that women should get a mammogram every two years instead of annually. But ultimately, the choice is up to the individual.
“Anyone who's been through it will know that you will often be called back because they saw something and you get false positives. It's very stressful. It can be expensive,” Rabin explains. “Some women have these callbacks constantly because of the way their breasts look under this imaging scan and it's really difficult. But they may also be worried about cancer to a greater degree, so that's an individual call.”
More young women are also being diagnosed with breast cancer. While it’s unclear why that is, Rabin says some people are engaging in behaviors that have higher risk factors. For example, some women are opting not to have children, or they want kids at a later age. “Women who have children tend to have less breast cancer. [And] women who breastfeed — that also seems to be protective.”
She adds that drinking is up in women, and alcohol consumption is another risk factor for breast cancer. Higher rates of alcohol intake can raise estrogen levels, which some cancers use to grow.
Then there’s breast density — or breasts with more glandular and fibrous tissue instead of fatty tissue. The denser the tissue is, the less likely the mammogram is able to detect the cancer. “They both look white on the screen. Dense tissue looks white, and the tumor looks white. So white on white, you just don't see it.”
This is relatively common, however. According to the National Cancer Institute, nearly half of women (40 or older) who get mammograms have dense breasts.
Why Black women have higher breast cancer rates
Why are Black women 40% more likely to die from breast cancer compared to white women? Rabin says they’re more likely to develop an aggressive form of breast cancer — triple-negative breast cancer — and often face delays in receiving proper treatment. This type of cancer grows and spreads quickly, and is also more likely to return post-treatment.
The panel’s recommendations note that while regular screening is a crucial first step, “it is not enough to improve these inequities.” They recommend follow-up conversations with health care providers and timely cancer treatments.