Screening Too Late For Black Women? One Doctor’s Expert Opinion On Latest Mammogram Guidelines
There are many “silent killer” medical conditions that we never know we have unless we have our complete physical exams and labs done. Screening tests exist for a reason: to screen. You don’t wait until you have a problem to get tested for the major medical conditions—you get preventive testing.
So, I decided, I’m going to get an early mammogram. I’m 37 years old, without any significant family history of breast cancer, fortunately, which generally puts me at low risk. I’ve recently stopped birth control pills and breastfed two babies, which also puts me at low risk. However, I was still nervous.
I treat many female patients, of all ages, and I’ve diagnosed a handful with breast cancer. Some of these women had “classic” or “textbook” risks, such as being in their late 40-60s with a family history or having an abnormal lump they found during a self exam. However, at least two or three patients within the past couple of years had zero risks. As a matter of fact, one that struck me as a surprise was one of my patients who was healthy as a horse. She was in her 30s, didn’t smoke, wasn’t on birth control, worked out all the time and no medical issues other than bloody discharge from the nipple. We sent her for an ultrasound and mammogram, her first one ever, really just as a precaution, and it was positive for cancer. I was as astounded as she was. She looked just like me.
I’ve asked friends and family and the majority of them know someone who has been affected by cancer in their 30s or 40s, without any family history of cancer.
Screening Guideline Changes: Too Late?
What has caused controversy recently is the change in the recommendations for when to start and how often to do mammograms. Within the last five years, the guidelines have changed, stating that we should wait until age 50 to start doing mammograms. This would mean not starting at 40, which is what I was accustomed to doing. The frequency was to do them every other year, which would be different from my practice as well.