October is National Breast Cancer Awareness Month, and the American College of Radiology (ACR) along with the Society of Breast Imaging (SBI) and other major medical organizations are encouraging women in their 40's to discuss yearly mammograms with their doctors.

Those organizations are involved in an effort to change the way benefits and dangers associated with mammo are perceived. Specifically, they believe annual screening starting at age 40 can save more lives and generate better breast cancer outcomes than any other screening protocol.

"According to data from the National Cancer Institute (NCI), since regular mammographic screening was introduced in this country in the 1980's, deaths from breast cancer dropped by more than 35 percent," said Dr. Debra Monticciolo, chair of the ACR Breast Imaging Commission, in a statement.
This position contrasts with the United States Preventative Service Task Force (USPSTF), which recommends that the decision to start screening mammography in women younger than 50 years old should be an individual one, and gives screening of 40-49 year old patients a "C" grade.

It states, "Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years." For women between 50-74, the USPSTF recommends biennial screenings. It bases those positions on a number of factors, including frequency of deaths avoided and resulting harm of the screening (which includes false positives).

The stance of the USPSTF is critical to the conversation because it may influence the coverage decisions made by insurers. "If they do not change their rating, women ages 40 to 49 will not have insurance coverage for screening and women at all ages will only be able to be screened every two years which gives cancers an extra year to grow and spread," Dr. Daniel Kopans, director of breast imaging at Massachusetts General Hospital, told HCB News.

Breast cancer is the second leading cause of deaths among women in the U.S. In 2015, according to the NCI, 231,840 women will be diagnosed with the disease and 40,290 will die from it. Deaths are highest among women who are not screened regularly and have their cancers found at later stage.

"While anxiety from test results and the possibility of further testing is real, and should be discussed, it doesn't outweigh the thousands of lives that are saved every year by screening mammography," said Monticciolo.

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