Demystifying Mammography

May 8, 2018
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Paint the Town Pink is a community wide effort presented by Hackensack Meridian Health to raise awareness of the importance of annual mammograms and women’s overall health and wellness.

By April Guillerme Dunic


Experts agree that early detection is a woman’s best defense against surviving breast cancer and that having regular mammograms is a critical part of early detection. However, different professional organizations, such as the American Cancer Society, the American College of Radiology, the Society of Breast Imaging and the United States Preventative Services Task Force, offer varying guidelines about when and how often women should obtain a mammogram, which can cause confusion.

Bokran Won, M.D., medical director of the Women’s Centers at Hackensack Meridian Health Riverview Medical Center and Hackensack Meridian Health Bayshore Medical Center, wants to help demystify the guidelines so that every woman is informed and empowered to manage her health.

“Despite mammography screening being commonplace since the 1980s, there’s still a lot of confusion about when a woman should have her first mammogram and how often she should obtain one thereafter,” said  Won. “A lot of that confusion stems from the fact that the professional organizations that set the guidelines, don’t agree.”

Bokran Wan, M.D., is helping to demystify breast screening guidelines so that every woman is informed and empowered to manage their health. Photo courtesy RMC

The American College of Radiology (ACR) and the Society of Breast Imaging (SBI) recommend that women of average risk start getting yearly mammograms at age 40 and continue annually as long as they remain in good health. However, the American Cancer Society (ACS) recommends that women start at age 45, while the United States Preventative Services Task Force (USPSTF), a group of physicians from varying practice areas, recommend that women of average risk should begin regular screening starting at age 50. In addition, those two organizations now recommend that women aged 55 and older transition to screenings every other year.

“One reason these organizations have changed their guidelines is due to over diagnosis,” said Won. “The fear is false positives, which could cause undue stress and anxiety for a woman, as well as an increase in biopsies.”

What the different organization do agree on, however, is that the decision should be made between the woman and her physician. “The majority of breast cancers occur in women who have no family history and who are of average risk,” said Won. “Since mammography became commonplace, the mortality rate from breast cancer among American women has decreased by 25 to 40 percent. This is largely due to early detection and improved treatment.” Breast cancers found in the early stages allow women to undergo less extensive surgery and less aggressive treatment.

Because early detection is so important, and despite the recommendations by the ACS and the USPSTF, many physicians continue to recommend that women begin getting screenings at age 40 and continue annually. Additionally, all four organizations support the belief that a woman should have the right to choose when she begins to get a mammogram.

“It’s extremely important to have an open dialogue with your physician about risks, fears, and benefits of having regular mammograms,” said Won. “We encourage all women to have a more personalized breast cancer screening regimen. Additionally, women who have risk factors should seek genetic counseling to develop a plan about when to have their baseline mammograms and whether to have supplementary screening tests such as breast MRI with contrast.”

The bottom line, according to Won, is that mammography screening is extremely important. “If you are a woman in your 40s and you have yet to have your first mammogram, call your doctor today and have the conversation. It really could save your life.”

This article was first published in the May 3-10, 2018 print edition of The Two River Times.


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