Sisterhood Blog

New Mammogram Guidelines Don't Apply To Those With BRCA Mutations

By Nadja Spiegelman

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New, less-aggressive guidelines for breast cancer screenings do not apply to women at high risk for the disease, such as those who have tested positive for the BRCA genetic mutations, which are most common in Ashkenazi Jewish women.

Released Monday by the government-funded U.S. Preventive Services Task Force, the new guidelines increase the recommended age at which most women should begin to get mammograms to 50, from 40. The task force, composed of “private-sector experts in prevention and primary care,” also recommends that women between the ages 50 and 74 get mammograms every two years — instead of annually — and that doctors stop teaching women how to do breast self exams.

Such changes to breast cancer screening protocols are not recommended for women at high risk for the disease. Those women are encouraged to speak with their physicians about when to begin screening.

“For women at high risk, the guidelines are different than those that apply to women who are 40 and have an ordinary risk of breast cancer,” said Rochelle Shoretz, the executive director of Sharsheret — a New Jersey-based organization that provides genetic counseling and support services to young, Jewish women with breast cancer and ovarian cancer.

Shoretz noted that many physicians have recommended that women who are at high risk begin testing at an age 10 years younger than the age at which an immediate family member had been diagnosed with breast cancer. “So if your mom had been diagnosed at age 40, you might want to begin testing at age 30,” she said.

Even for those who are not at increased risk for the disease, it may seem counter-intuitive to reduce the amount of testing. But the medical experts on the task force contend over-testing increases the likelihood of unnecessary procedures, such as biopsies, and can cause extreme anxiety.

Despite such risks, responses to the new guidelines from some in the breast-cancer community have been quick and visceral. ABC News has the images and stories of several women who believe that mammograms before 50 saved their lives.

And in an open letter to the breastcancer.org community, Dr. Marisa Weiss, founder of Breastcancer.org, wrote:

The task force members felt that the amount of money saved (from fewer mammograms and side effects of extra biopsies and treatment) was greater than the value of more lives saved (3% fewer women surviving breast cancer).

On Capitol Hill, there are grumblings — especially among Republicans who oppose the healthcare legislation put forth by Democrats in Congress — that these new guidelines may be the top of a slippery slope toward rationing health care.


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