Doctor recommends regular mammograms starting at age 40

Recent reports have sent conflicting messages to women about when they should start having regular mammograms. Dr. Antoinette Cortese, M.D., director of Women's Imaging for Carson Tahoe Regional Medical Center and Sierra Surgery, recommends that all women, beginning at age 40, should get an annual mammogram, regardless of risk factors.

"If you only screen high-risk women you will miss the vast majority of breast cancer because 75-90 percent of women who develop breast cancer are not at an increased risk," says Cortese. "After looking at the results from annual screenings, the mortality rate has decreased 30 percent. Prior to that, the mortality rate hadn't changed for 50 years."

Dr. Cortese also says that in September, the Department of Health and Human Services issued new regulations that new health care plans must cover yearly mammograms for women, aged 40 years and older without charging a co-pay or deductible.

"This directly contradicts the 2009 U.S. Preventive Services Task Force, which had recommended screenings every two years beginning at age 50," added Cortese. "I agree with the American Cancer Society. Annual screening mammography, beginning at age 40, saves lives."

About one in eight women who reach the average age of 80 in the United States will develop breast cancer in her lifetime. About 90 percent of breast cancers are due to genetic abnormalities as a result of the basic wear and tear of life. As women get older, their risk of developing breast cancer increases. However, there are a number of individual factors that would adjust the risk.

One of the most determining factors is family history. Women who have inherited mutations in the genes can increase their risk to as much as 85 percent. Other inherent factors include reproductive history (childbearing history), age and race/ethnicity.

Not all factors are inherent. Other risk factors can be controlled. As an example, alcohol consumption can increase the risk of developing breast cancer. Compared to women who do not drink, women who have two or more drinks per day have a 25 percent higher risk of breast cancer. Other controllable risk factors include weight, smoking and physical activity. Be sure to check with your physician about all potential risk factors for developing breast cancer.

Although gender plays one of the biggest roles in all risk factors, breast cancer can also appear in men. Less than one percent (about 1,970 cases) of all new breast cancer cases occurs in men. While breast cancer in men is rare, just like women, age is the largest determining factor and occurs most in men between the ages of 65 and 67.

Whether you are a male or female, self-awareness is the key. Breast self-exam (BSE) is a tool that may help you become familiar with the normal look and feel of the breast. If you notice any of the warning signs below, see your physician or health care provider right away:

• Lump or hard knot

• Swelling, redness or darkening

• Change in the size or shape of the breast

• Dimpling or puckering of the skin

• Itchy or sore rash on the nipple

• New pain in a spot that doesn't go away

Many women find that their breasts feel lumpy. There is much variation in breast tissue among women, and by nature, breast tissue has a bumpy texture. In most cases, lumpiness is no cause to worry. If it is felt throughout the breast, and is similar between both breasts, it is probably just normal tissue. If lumps feel harder from the rest of the tissue, there could be reason for concern. In this case, a physician visit is recommended.

A clinical breast exam (CBE) is a physical exam performed by a health care provider and is a simple test that should be done as part of your regular medical checkup. It is important to make certain your provider is well trained in the technique to provide the best results and CBE's should become part of a routine screening in women beginning at age 20. A CBE should be done every three years until age 40, when women should begin a mammogram every year.

It is important to know there is a tremendous amount of research under way to help establish effective ways to prevent breast cancer, and if you are diagnosed, there are over 2.5 million survivors in the United States.