New guidelines for breast cancer screening from the United States Preventive Services Task Force have been widely reported in the media. Karmanos Cancer Center breast cancer specialists are not adopting these new guidelines. We recommend that:

1. Beginning at age 40, women should speak to their doctors about mammography to understand the potential benefits and risks, and determine what is best for them.
   For a number of years, there has been a valid debate within the medical community over the most appropriate age and frequency of mammography screening for breast cancer. There is no debate, however, over the fact that mammography reduces the risk of dying from breast cancer. As stated in the USPSTF recommendations, extensive scientific evidence shows that mammography reduces breast cancer mortality both among women aged 50 and older, as well as among women aged 40 to 49. However, the benefits are less in women aged 40-49.
   
   
2. It is very important for patients and their physicians to discuss the benefits vs. risks of mammography screening.
   Mammography is the best tool we currently have for detecting breast cancer; however, it is not perfect. Sometimes mammograms miss a cancer. Other times, a mammogram suggests that a woman has cancer when she does not. There is a risk of false positive results, particularly in younger women with dense breast tissue. False positive mammograms can lead to unnecessary biopsies and other additional tests. There is also the risk of over-diagnosis and finding tumors that would not have clinically surfaced in a woman’s lifetime, among all individuals age 40 and older. This may lead to overtreatment.
   However, mammography remains the best tool for physicians to detect a tumor that is too small to be felt. Patients must talk to their doctors to determine what screening schedule is most appropriate for them.
   
   
3. Continue with self-breast exams.
   There is not universal agreement that self-breast exams save lives. However, Karmanos treats women who have discovered their own tumor through self-exam. Women need to be familiar with their bodies and immediately contact their physician if they detect a lump or other abnormality.
   
   
4. None of the discussions about the new guidelines apply to women who are considered to be of high risk for breast cancer. This includes, but is not limited to:
   
   --Anyone who has a strong family history of breast cancer including women who carry a harmful mutation in the BRCA1 and BRCA2 genes (Hereditary Breast and Ovarian Cancer Syndrome) or other women who are not carriers of a BRCA1 or BRCA2 mutation but who have a first degree relative (mother, daughter or sister) with a premenopausal breast cancer
   
   --Women with a history of breast cancer
   
   --Women who detect a lump in their breast
   
   In summary, all women need to be well-informed of the risks and benefits of breast cancer screening. We highly encourage women to have an open and frank discussion with their physician.