American cancer society com

The new ACS guidelines for the early detection of breast cancer are:

* Yearly mammograms starting at age 40.

* Clinical breast exams should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for women 40 and over.

* Women should report any breast change promptly to their health care providers. Breast self exam is an option for women starting in their 20s, screening earlier, having additional tests (breast ultrasound or MRI), or having more frequent exams.

* Women at increased risk (e.g.: family history, genetic tendency, past breast cancer) should talk with their doctors about the benefits and limitations of starting mammography

* Screening earlier, having additional tests (e.g. breast ultrasound or MRI), or having more frequent exams.

These ACS guidelines have been updated as of May 14, 2003. Guidelines released from the National Guideline Clearinghouse and the US Preventive Services Task Force February, 2002 differ somewhat. The US Preventive Services Task Force recommends screening mammography, with or without clinical breast examination, every 1-2 years for women aged 40 and older. They note that the evidence is strongest for yearly screening mammography for women aged 50-69. For women aged 40-49, the evidence that screening mammography reduces death from breast cancer is weaker,

and the absolute benefit of mammography is smaller, than it is for older women. Most, although not all, studies indicated a mortality benefit for women undergoing mammography at ages 40-49. The delay in the observed benefit in women younger than 50 makes it difficult to determine the clear benefit of beginning screening at age 40. They also concluded that the evidence can be generalized to women aged 70 and older and that the benefits vs the potential harms of mammography grows more favorable as women age when the risk of breast cancer is higher. The US Preventive Services Task force also concludes that the evidence to recommend for or against routine clinical breast examination alone to screen for breast cancer and recommending for or against routine breast self-examination is insufficient.

Resources: American Cancer Society May 2003. US Preventive Services Task Force February 2002

Tori Hudson, ND

Professor, National College of Naturopathic Medicine and Bastyr University

Medical Director, A Woman's Time

Author, Women's Encyclopedia of Natural Medicine

2067 N.W. Lovejoy * Portland, Oregon 97209 USA

503-222-2322 * womanstime@aol.com