Family Forum: Breast Cancer Screening

At what age should I start getting mammograms?

QUESTION:

I’m a 43-year-old woman, healthy and normal weight. My doctor says she urges all her 40-plus female patients to have a mammogram and it’s covered by Medicare. I’m not sure it’s such a good idea, the government only asks women to do this after the age of 50. What does the panel think?

ANSWER:

Studies have shown that earlier mammograms save more lives. There are different recommendations for different groups, however, which makes things a bit confusing.

While many places around the world screen later (often women 50 years and older), the essence is that earlier screening may detect potentially dangerous cancers sooner, enabling more effective treatment. This might be particularly important if the person is at greater risk of developing breast cancer, in cases where there is a strong family history or higher genetic risk of the disease.

A potential drawback, however, is that screening might detect non-cancerous tumours resulting in avoidable anxiety, or a person having potentially more aggressive treatment for a tumour that might have not been necessary. The Royal Australian College of General Practitioners guidelines state that while screening mammograms in women aged 40–49 years may reduce the risk of dying of breast cancer, the number of deaths averted is much smaller than in older women, and the number of false-positive tests and unnecessary biopsies are larger.

The key is having good evidence-based information and clear understandings and expectations. It is the GP‘s responsibility to make sure that patients are properly informed and aware of their risk factors and situation so they can make decisions about their health – including screening – that are best for them. It is recommended that you speak candidly with your GP about your concerns regarding cancer risk and screening and get as much information as you can, so that you are able to make an informed decision that you are comfortable with. If your GP cannot help you with this, it is a good idea to see another GP or ask for a referral for another opinion.

The college also recommends that all women, whether or not they undergo mammogram screening, are aware of how their breasts normally look and feel, and promptly report any new or unusual changes (such as a lump, nipple changes, nipple discharge, change in skin colour, pain in a breast) to their GP.