Based on the American Cancer Society's recomendations, a 46 year old healthy female with no family history of breast cancer should be given the following recommendation:
2. Every year.
According to the American Cancer Society(ACS) guidelines, a healthy woman aged 46 years should get a mammogram annually. ACS recommendations states that women between the ages 45 - 54 with average risk of breast cancer should have annual mammograms. This is because at this age, women are most likely to be in the early stages of breast cancer and regular screening can benefit them in terms of an early diagnosis. Also at this age, benefits of regular screening far outweighs the risks associated with biopsies, overdiagnosis and false positives.
Now, these options are incorrect because:
1. Inform her that she has an option to start screening with a mammogram every year.
The ACS recommends that women aged 40 - 44 should have the opportunity to start annual screenings with a mammogram. This depends on the informed decision making undertaken by the concerned women with their healthcare provider. At this age, risks of mammogram may potentially outweigh its potential benefits. However, a woman in this age range should be given the opportunity to undergo regular mammograms if she so desired. For a woman beyond 45, regular annual mammograms are strongly recommended regardless of their risk of breast cancer.
3. Every 2 years.
This is ACS's recommendation for women beyond 55 years of age. Though post menopausal women are at a higher risk of contracting breast cancer, since breast cancer has a slower rate of growth and is more easily detectable in less dense tissues, at a younger age, women older than 55 are advised to undergo a screening by mammogram every 2 years instead of every year. There is no proven statistical advantage in undertaking annual mammogram at this age. However, below this age, annual mammograms are highly recommended as the chances of an early diagnosis is maximum.
4. She does not need screening with a mammogram at her age.
Mammogram is usually not recommended in women of average risk under 40 years of age. At this age, the risk of contracting breast cancer is relatively low and the risks of damage due to overdiagnosis and false positive results are potentially higher. However, over 45, the risk of breast cancer increases substantially and the potential benefits of mammogram outweighs any risks associated with it. Hence, a 46 year old should have annual mammograms.
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