From the New York Times blog, examples of digital mammography (left) and traditional X-ray mammography (right).

Last year, there was a media uproar over the change in guidelines for routine mammograms. The U.S. Preventive Services Task Force (USPSTF) changed their guidance to suggest that women at average risk for breast cancer shouldn’t get their first mammogram until age 50, then every two years thereafter.

In contrast, the American Cancer Society (ACS) suggests that breast self exams begin in the 20s and yearly mammograms begin at age 40.

Why the difference?

Women in their 40s are more likely to have false positive readings on a mammogram. The USPSTF believes that the physical and psychological risks of further diagnostic tests, procedures and surgeries outweigh the benefits of mammography in this age group for women at average risk.

What makes you average risk vs. high risk?

Breast cancer risk is increased by a history of breast or ovarian cancer in a parent or sibling, radiation treatment to the chest area or previous abnormal breast biopsy. Discuss your personal and family medical history with your doctor.

What are doctors saying?

Mayo Clinic, for example, has adopted a policy where women are encouraged to do monthly breast self-exams to detect any abnormalities that may develop. Clinical breast exams and mammograms will begin at age 40.

Palo Alto Medical Foundation, a healthcare group in Northern California, put together a statement about mammogram recommendations, noting that the choice of when to begin mammograms is a personal one to be made with the guidance of a physician, and that insurance coverage for mammograms should not be a deciding factor.

So what’s the right answer?

If you’re in the 40-49 age group, discuss it with your doctor. He or she will take into account a variety of risk factors, including family history, to determine when your mammograms should begin.

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