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Mammograms Still 'The Gold Standard' for Detection

Despite advances in medical technology, women are best served by routine and traditional mammograms, says breast surgeon

It seems like recommendations for women seeking to detect and prevent breast cancer change from month to month. However, a local breast surgeon says that mammograms still provide the best chance for early detection of breast cancer.

"The recommendation remains to begin mammograms for women at age 40, and yearly thereafter until her overall health would deem them unnecessary," said Dr. Jodi Brehm, a breast surgeon with Wheaton Franciscan Healthcare's comprehensive breast care program.

Only three years earlier, the medical community had to combat a report from the United States Preventive Services Task Force. Based on a review of scientific studies recommended women under the age of 50 no longer needed screening mammograms, and women between the ages of 50 and 74 should only be screened every two years. Breast self-exams were no longer recommended.

However Brehm credits ongoing awareness efforts for helping to get the word out to women to get checked regularly.

Depending on your physician, some may request a baseline screening at the age of 35, with yearly followups beginning at 40, and women who have a history of early breast cancer (considered under the age of 40) would likely begin the screenings at 30.

While some women would prefer to get tested early to reassure themselves, Brehm said studies don't support their necessity.

"At this point it just doesn't make sense to test earlier than 40 for most women; it's just not cost-effective. Without a family history of early breast cancer, it's very rare to get it under the age of 40," she said.

Other testing is available, like ultrasounds and breast MRIs, but Brehm said those take longer to complete and are 'tech dependent,' used more often to diagnose rather than detect.

"The mammogram is still the gold standard for detection and as more women come in to have them done we are seeing greater success in treating while we're also diagnosing more cancers in the earlier stages," she explained. "It's not a perfect tool, but the mammogram has an 80 percent specificity rate (a measure of accuracy); it's not going to pick up everything, but it will be able to pick up those signs to suggest further testing."

While genetics and family history can play a role in a woman's odds for getting breast cancer in the instance of cancer under the age of 40, Brehm said the vast majority of women - 70 percent - have no family history.

"The biggest risk factors remain being a woman and getting older," she said.

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From what I have read, MRI's are actually more the "Gold Standard" and are more accurate for breast cancer detection. Why don't women get MRI's instead of mammograms? Bottom line: cost.
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