Breast Cancer Guidelines Seek More Patient Involvement

Society says women in 20s needn't do self-examinations

Edward Edelson

Edward Edelson

Published on May 14, 2003

WEDNESDAY, May 14, 2003 (HealthDayNews) -- The American Cancer Society is issuing new breast cancer screening guidelines that encourage women to take a more active role in the process and loosen the recommendations for self-examination.

The guidelines envision an ongoing conversation between women and their physicians, says Debbie Saslow, director of breast and gynecological cancer for the organization.

"We're talking about women knowing and discussing the benefits and limitations of screening," Saslow says. "We are giving them information to be more proactive, if that is what they choose to be."

The newly published guidelines include a lot more information about screening methods to help women participate in decisions, she says. For example, "there is a more thorough review of various technologies other than mammography, such as ultrasound and magnetic resonance imaging," Saslow says.

The society is no longer recommending that all women start breast self-examinations in their 20s. Instead, "we refer to women in their 20s and 30s," Saslow says. "We emphasize that younger women should realize that their risk is very low. Breast self-examination is now an option."

Most of the other guidelines are unchanged. They include:

  • Annual mammograms starting at age 40 and continuing for as long as a woman is in good health. "It's important to note that while the mammography recommendation has not changed, the evidence supporting it is stronger than ever," Saslow says.
  • Clinical breast examinations as part of a periodic health examination, about every three years for women in their 20s and 30s and every year starting at age 40.
  • Prompt reporting of any breast change to a health-care provider.
  • An emphasis on having women at increased risk because of such factors as family history, genetic tendency or a previous breast cancer talk to their doctors about the benefits and risks of different screening methods.

That last recommendation is appropriate because "our experience with this population is evolving and we don't have any clear-cut answers," says Dr. D. David Dershaw, director of breast imaging at the Memorial Sloan-Kettering Cancer center and president of the Society of Breast Imaging. "Our recommendations may change at very short intervals. These guidelines recognize that there is a controversy about screening technologies to be used and the appropriate schedule for their use for women at high risk."

In general, Dershaw says, the new guidelines "are an accurate representation of what most experts in the field would feel appropriate."

The guidelines now allow more flexibility in terms of age, Saslow says. They say decisions about screening should be based not only on a woman's age but also on her general health status. "A woman who is 85 and in excellent health has enough years in front of her to benefit from screening, while a woman of the same age with major health problems may not," she says.

More information

Learn more about the disease from the American Cancer Society, and on screening techniques from the National Cancer Institute.

Read this Next
About UsOur ProductsCustom SolutionsHow it’s SoldOur ResultsDeliveryContact UsBlogPrivacy PolicyFAQ