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Guidelines for Breast Cancer Screening Keep Evolving

When and how often should women be screened for breast cancer? Conflicting recommendations about this are a concern because, if a mammogram isn't performed when it should be, the result can be a failure to diagnose cancer - and that failure can have lethal consequences.

With the stakes so high, failure to diagnose breast cancer can constitute medical malpractice.

So what are the latest recommendations on mammograms from the relevant authorities?

In late July, the American College of Obstetricians and Gynecologists revised its recommendations on breast cancer tests. The recommendation is now for yearly mammograms, beginning at age 40.

This is somewhat more frequent testing than the group's previous recommendation, which called for women to get the test every year or two in their 40s, with annual exams starting at age 50.

A group of researchers, however, has questioned the use of bright-line age-based guidelines on breast cancer testing. They argue that other factors should be considered, such as the density of breast tissue, a family or personal history of breast cancer, and patient preferences.

"Age is a starting point, but it's not the full picture," said Jeanne Mandelblatt of Georgetown University's cancer center. "We're not all the same . . . at any given age," she added.

The conflicting information on breast cancer screening has been a problem for several years. In 2009, the U.S. Preventive Services Task Force changed its guidelines to call for screening every other year of average-risk women between ages 50 and 74. Women in their 40s were encouraged to discuss the issue with their doctor. The task force had previously recommended mammograms every year or two beginning at age 40.

Conflicting information is indeed a challenge, but it does not excuse failure to diagnose cancer.

Source: "New Advice on Mammogram Timing" Wall Street Journal, 7-25-11

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