Should Women Over Forty Have Routine Mammograms?

QUESTION: I'm forty and my gynecologist recently suggested that I have my
first mammogram done and then go routinely every two years. Do you agree?
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ANSWER: At about the age of forty, most physicians feel that women should
have their first mammogram done, and I'm in total agreement. They should
continue having them regularly at two-year intervals up to about the age of
fifty. At that age the American College of Radiology recommends yearly
mammograms. I tend to think that the two-year interval can be maintained even
for women in their fifties.
Of course, women in their twenties and thirties at high risk for breast
cancer should have them done immediately. These are women with histories of
breast cancer in their families, and, of course, with them a mammogram should
be performed now, not at the age of forty. This is not a scare tactic but
just plain common sense. The earlier that a cancer is detected the better the
outcome. And for women who are premenopausal with family histories of breast
cancer, the risk is the greatest. So don't be alarmed at the advice of your
gynecologist. It is a precautionary regimen in medicine aimed at prevention.
Mammograms are simply and expertly done with no pain to the patient.
A recent patient of mine, who happened to be thirty-five, went for her
first mammogram, because her mom had breast cancer in her thirties. A small
mass less than 1 cm in diameter was found, and before I referred her to a
specialist I wanted to assure her and discuss her options. Malignancy was
suspected even before the biopsy. First I told her exactly what would happen
in the biopsy to allay some of her fears. When the biopsy proved positive, we
discussed the options within the surgery. Because of the small size of the
lesion, I told her that her disease was in its very early stages. Since this
was the case, she had had the option of lumpectomy (the removal of part of the
breast with the growth) and follow-up radiation therapy. A radical mastectomy
(complete removal of both breasts) was not necessary in her case. More and
more research is indicating that lumpectomy followed by radiation is just as
effective, possibly more so, than mastectomy in treating breast cancer. More
breakthroughs occur daily in our fight against breast cancer.