Although the USPSTF continued to encourage regular mammograms starting at age 40, many of these women were not covered by its formal recommendations. This meant they would only be diagnosed when they noticed abnormalities in their breasts, such as lumps, thickening or swelling, and nipple discharge other than breast milk.
When the USPSTF team looked at the new data, Wong says, they lowered the age for first mammograms to 40 years old.
However, instead of proposing annual mammograms, the task force changed their frequency to once every two years. This change has raised concerns and criticism from some specialists.
“Overwhelming data shows that most lives are saved with annual screening starting at age 40,” says Aviva O’Connell, a breast imaging specialist at the University of Rochester Medical Center in the state. from New York. “If we delay screening until age 50 and only order one test every two years, as many as 100,000 women will die from breast cancer. »
Dr. Shah shares this opinion. “We want to start screening earlier because these cancers are more aggressive. We don’t want to wait two years. »
Other doctors worry about the impact on insurance coverage and health equity. Under the Affordable Care Act in the United States, all health insurance companies must cover 100% of the cost of recommended screening mammograms. While some insurance plans may maintain full coverage for annual mammograms once women turn 40, others may move to biennial coverage, as this remains within the law.
Given that women of color are much more likely to develop breast cancer, be diagnosed at a later stage, and die from their disease, this lack of coverage will create a major health equity issue. health, says Toma Samantha Omofoye, a breast radiologist at the University of Texas MD Anderson Cancer Center.
“Cancer disparities are caused by issues that affect healthcare overall. “That’s why access to early and frequent screening mammograms is an important part of addressing health disparities,” she adds.
For some people, however, even annual screenings may be insufficient.
The widespread use of mammography has also raised awareness of the difficulties associated with dense breasts. Women who have dense breasts (usually young women) have more fibrous and connective tissues that provide structural support to the breast. This tissue is denser than fat and glands, and appears white on mammograms.
Dense breasts are not a problem in themselves, Shah says, but they make it more difficult to identify potential tumors on a mammogram. That’s why doctors have started encouraging women with dense breasts to have additional imaging tests (MRI and ultrasound) in addition to their annual mammograms.
To ease the burden of screening, scientists are working to develop new, more accessible breast cancer screening technologies.
This is the case of Canan Dagdeviren, an engineer at MIT’s Media Lab, who is designing a portable ultrasound device that women can use with their everyday bra. She sketched her prototype at the bedside of her dying aunt, whose breast cancer occurred between twice-yearly mammograms. When Dagdeviren’s aunt detected changes, her cancer was too advanced to be treated.
Dagdeviren suggests that women could use her device every month, every week, or even every day, as part of their routine, because the ultrasound only takes a minute or two.
“Early detection is the key to survival. Our calculations show that this technology has the potential to save 12 million lives per year worldwide,” she says.
And she doesn’t want to stop at breast cancer. Other types of tumors, such as prostate cancer, could also be detected using portable ultrasound.
Even as researchers like Dagdeviren continue to develop the screening tools of the future, O’Connell says that simply knowing your own body and paying attention to changes remains one of the most important strategies in cancer detection. .
“You have to know what is normal for you to notice if something has changed,” she emphasizes.
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