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New guidelines back mammograms starting at 40

All women should begin mammogram testing at 40, and at 30 for high-risk cases.

This is according to guidelines released on Monday by two groups that specialize in breast imaging, contradicting controversial guidelines from a U.S. advisory panel last year.

The joint recommendations from the American College of Radiology and the Society of Breast Imaging take into account the success of annual mammography screening starting at age 40, said Dr. Carol Lee of Memorial Sloan-Kettering Cancer Center in New York, whose study appears in the Journal of the American College of Radiology.

The recommendations have been in the works for about two years, but they serve in part as a rebuttal to guidelines issued in November by the U.S. Preventive Services Task Force, which recommended against routine breast mammograms for women in their 40s to spare them some of the worry and expense of extra tests to distinguish between cancer and harmless lumps.

Those recommendations contradicted years of messages about the need for routine breast cancer screening starting at age 40, sparking a rebellion from breast cancer specialists who argued the guidelines would confuse women and result in more deaths from breast cancer.

The recommendations also cover the use of magnetic resonance imaging or MRI and breast ultrasound in women who are at high risk of breast cancer because they have mutations in the BRCA1 or BRCA2 genes or a family history of breast cancer.

In these women, breast mammograms should begin by age 30, but not before age 25, when the risk of radiation exposure from the mammograms begins to outweigh the benefits of screening.

The two groups did not consider the harms associated with routine screening at an earlier age, such as false positive results, which the task force was trying to balance.

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