FOR EXPERT COMMENT: Doctors, Women Should Spend More Time Discussing Mammograms

August 9th, 2011

The views and opinions expressed in this “for expert comment” release are based on research and/or opinions of the researcher(s) and/or faculty member(s) and do not reflect the University’s official stance.

COLUMBIA, Mo. – Due to changing guidelines concerning when and how often they should first be screened for breast cancer with mammograms, many women are confused. The American Cancer Society recommends women 40 years and older get a mammogram every year, but the U.S. Preventive Services Task Force recommends mammograms every other year for women older than 50. A University of Missouri researcher says doctors and patients should communicate better about individual patients’ timing of breast cancer screenings.

“The science related to breast cancer and mammography screening is continually evolving,” Julie Kapp, assistant professor in the Department of Family and Community Medicine in MU’s School of Medicine, said. “Conflicting guidelines across organizations suggest there is still a lot of work to be done to send consistent messages to women and health care professionals to ensure quality care.”

Although the current guidelines suggest varying ages at which women should get mammograms, recommendations in previous years have ranged from age 35 to age 50 for initial screenings. Kapp says women younger than 50 should talk with their physicians to customize the age at which they begin mammography screenings. Decisions should be based on women’s preference, risk factors and understanding of the benefits and harms of mammograms. Women should also be aware that total health, including diet and exercise, is important for breast health and to reduce the risk of other diseases.

“Women who get mammograms before age 40 are more likely to be subjected to the harms of mammograms that many people don’t consider,” Kapp said. “The tests are not as accurate in younger women, so they can produce false positive results. That means time spent worrying about whether they have cancer, unnecessary biopsies and additional radiation exposure.”

In a pilot study, Kapp is working to understand women’s knowledge about mammography and their feelings surrounding breast cancer screening conversations with their physicians. Kapp aims to help women understand the advantages and disadvantages of mammograms and help improve the dialogue between patients and health care providers about the best time to begin breast cancer screenings.

The goal of the study is not to encourage women to avoid mammograms, but to discover more effective ways to educate women on the benefits and risks of breast cancer screenings as well as to improve communication between doctors and patients.

“Most of the information women get about mammograms does not come from their physicians; it comes from friends, family and the Internet,” Kapp said. “Women and doctors should have frequent conversations about their overall health and breast cancer screenings.”

The pilot study is funded by the MU Research Council. Kapp has an adjunct appointment with the MU Master of Public Health Program.