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Which mammogram recommendation to follow
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For decades, the American Cancer Society has recommended women have yearly mammograms beginning at age 40.

The ACS recently changed the guidelines, stating women now may wait until 45 to begin mammograms screening and discontinue annual mammograms at age 55, opting instead for every other year.

Many other health care experts, however, including the American College of Radiology and the Society of Breast Imaging, disagree. They continue their recommendation of women having yearly mammograms starting at age 40 or sooner in certain circumstances and continue annually as long as their health is good.

So what do you do when you receive conflicting recommendations?

As a woman and a radiologist, I think there’s something extremely powerful about taking control of our own health care choices. And that starts with gathering medical recommendations, talking with your physician and using the information to make an educated choice.

In my own profession, it has become readily apparent to not wait until 45 to begin screening. The number of breast cancers we have identified at Northeast Georgia Medical Center in women who are in their 30s and early 40s supports this.

So why is the ACS recommending a later start date?

Dr. Kevin Offenger, who chaired the independent panel that created the new guidelines, said one of the reasons behind the delayed age is the density of younger women’s breast tissue. He points out as a woman ages, her breast tissue tends to get less dense, making a reading easier.

But thanks to the new digital tomosynthesis technology — which is available at the Northeast Georgia Medical Center Imaging Center in Braselton — scanning dense breast tissue is easier than ever because of the multiple views or “slices” offered by the mammogram.

More commonly known as a 3D mammography, digital tomosynthesis exams take only a few seconds longer than a traditional mammogram and the 3D images are proven to detect 41 percent more invasive breast cancers than traditional mammograms.

Traditional mammograms give radiologists a flat, two-dimensional representation of the breast.  The new technology creates a 3D image using many layers of the breast, so fine details are more visible and no longer hidden by the tissue above or below. This means radiologists have to do fewer callbacks for repeat exams because what appeared to be questionable in a traditional image may be very clear in a 3D image.

The patient experience for 3D mammography is similar to a traditional mammogram: no additional compression is required, and the exam takes only a few seconds longer for each view. Very low X-ray energy is used during this exam, so radiation exposure is minimally increased when receiving a traditional mammogram along with a 3D mammogram. Medicare and Medicaid fully cover the new technology, and some commercial payers are beginning to do so as well.

Early detection of breast cancer in the past few decades has dramatically increased breast cancer survival rates, with a 98 percent 5-year survival rate of localized breast cancer cases. Eight out of nine women diagnosed with breast cancer have no family history, and a woman’s chance of developing breast cancer in her lifetime is 1 in 8.

Whether you opt for a 3D or traditional mammogram, early detection is vital.  It means we can catch things earlier. And the sooner we identify a problem, the less invasive the treatment will have to be.

Take the first step to protect yourself today.


Dr. Julie Pardue Presley, MD, is with the Gainesville Radiology Group and the medical director of Women’s Imaging at Northeast Georgia Medical Center.