Is it just me or does it seem that screening guidelines are in a constant state of flux? I mean, the recommendations for when to get, how often to get, and who should get pap smears seems to change on an annual basis…..
I know what I/We as gynecologists recommend for colon screening guidelines, yet it seems that as soon as I recommend a colonoscopy every 10 years, I have a patient who comes in and says that her GI recommended a repeat in 5 years(in some cases even without a significant family hx, or structural finding such as a polyp)…….I haven’t quite been able to obtain a general consensus from my GI friends on how often to get colonoscopies……
AND NOW THIS……..
While seeing patients, returning phone calls, perusing my emails……I see the new ACS(American Cancer Society)Guidelines on Mammography…….
The most notable changes are:
- the recommendation for screening mammography to begin at the age of 45 instead of 40
- annual screening mammography between the ages of 45 and 54; biannually thereafter
- Continuing with mammography screening as long as the individual is in good health and has an overall life expectancy of at least 10 years.
- No further clinical breast examinations…..regardless of age
Being creatures of habit, I’m sure this is going to take some time to implement…..just look at the most recent pap smear guidelines……..Not only are patients reluctant to follow them, but lots of clinicians still have yet to change their clinical practice as relates to the them(the most current pap smear guidelines).
I am anxiously awaiting ACOG’s(The American College of Obstetrics and Gynecology)position on these new proposals.
I do understand the commendations and the rationale behind them; specifically with the over testing, false positive results, unnecessary biopsies, and additional imaging that can be the result of screening mammography…..anyone who has ever been told they have DENSE BREASTS can likely relate to this.
All recommendations aside, I am a HUGE proponent of BREAST AWARENESS. That is knowing what your breasts normally look and feel like. If you notice ANY changes from YOUR baseline, it is IMPERATIVE that you notify your physician. ACOG is a HUGE endorser of this(Breast Awareness). In their bulletin on Breast Cancer Screening (Practice Bulletin #122)they note:
“this concept has arisen because approximately one half of all cases of breast cancer in women 50 years and older and more than 70% of cases of cancer in women younger than 50 years are detected by women themselves, frequently as an incidental finding”(please see ACOG practice bulletin #122 for direct reference to the source of these stats).
This is an opportunity for you and your clinician to take a good look at your general health, risk factors, and preferences with regards to screening mammography. It’s important to be aware of the pros/cons associated with what is being proposed. ONLY YOU can decide what is going to be in YOUR best interests. Challenge YOUR clinician to give you the facts so that YOU can make an informed decision regarding when to initiate mammograms, how often to get them, and when to discontinue them.
Hoping this blog post has added value to your day!
Until next time,
Look Better. Feel Better. Be Better.
Dr. Angela
