||Should I get a
are differing opinions in the medical community
about the value of mammograms in women under age
50, as shown in Chart 1. Some
feel that even if only a few deaths are
prevented, the time, worry, extra diagnostic
tests and discomfort are worth it. Others may
feel it is not worthwhile since so few deaths are
prevented by early detection and that the risks
of having a mammogram outweigh the potential
benefits. Others feel the benefits and risks are
sufficiently mixed that women should weigh the
potential benefits and risks and make a personal
There are also differing opinions in the medical community about the
value of mammograms in women age 70 and older. Some feel that women
should continue to have mammograms if a woman is in good health and
does not have co-morbid diseases and chronic medical problems.
Others may feel it is not worthwhile since early detection will
increase the rate of surgical treatment of small invasive cancer and
DCIS (see question 17) with little hope of impacting overall mortality
given that older women in general have shorter life expectancies and
higher risk of death from heart attacks and strokes than younger women.
Others feel the benefits and harms are sufficiently mixed that an older
woman should weigh the potential benefits and harms and make a personal decision.
agree that the following women should consider
having routine mammograms:
- women who have already had
breast cancer at any age
- women with a family
history of breast cancer in a mother,
sister, or daughter
- women age 50 to 69 years
Mettlin C, Smart CR. Breast cancer detection guidelines
for women aged 40 to 49 years: rationale for the American
Cancer Society reaffirmation of recommendations. CA
Cancer J Clin 1994;44:248-255.
American College Radiology. Policy Statement: Guidelines
for Mammography. Reston, VA: American College of
Eddy DM (ed). Common screening tests. Philadelphia,
American College of Physicians, 1991.
U.S. Preventive Services Task Force. Guide to clinical
preventive services. (2nd ed.) Baltimore: Williams &
Canadian Task Force on the Periodic Health Examination.
The periodic health examination. 2. 1985 update. Can Med
Assoc J 1986;134:724-727.