--- title: American Cancer Society Changes its Mammography Recommendations description: The American Cancer Society (ACS) updated its guidelines for breast cancer screening, which includes the recommendation that women at an average risk for breast cancer undergo regular mammography screening beginning at age 45. canonical: https://time.com/4077672/american-cancer-society-mammography/ author: Alexandra Sifferlin article:opinion: false article:content_tier: free article:published_time: 2015-10-20T15:00:30.000Z article:modified_time: 2026-08-04T07:57:25.567Z article:section: Health og:title: American Cancer Society Changes its Mammography Recommendations og:description: The American Cancer Society (ACS) updated its guidelines for breast cancer screening, which includes the recommendation that women at an average risk for breast cancer undergo regular mammography screening beginning at age 45. og:url: https://time.com/4077672/american-cancer-society-mammography/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt936a5938ac00481d/698868f2cf40a8237cc4044e/breast-cancer-02.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 2560 og:image:height: 1440 og:image:alt: breast cancer og:type: article twitter:card: summary_large_image twitter:title: American Cancer Society Changes its Mammography Recommendations twitter:description: The American Cancer Society (ACS) updated its guidelines for breast cancer screening, which includes the recommendation that women at an average risk for breast cancer undergo regular mammography screening beginning at age 45. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt936a5938ac00481d/698868f2cf40a8237cc4044e/breast-cancer-02.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # Mammogram Guidelines Get an Overhaul—Again > Sponsored content. 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Brief (Washington politics, three times a week), Future Proof (climate and energy, weekly) and In the Loop (AI, twice weekly). All are free at time.com/newsletters and together reach more than 1.1 million engaged readers. #### Which TIME newsletter should I subscribe to? It depends on what you follow. For a daily briefing, The Brief. For health, Health Matters. For Washington politics, D.C. Brief. For AI and technology, In the Loop. For climate and energy as a business story, Future Proof. For culture recommendations, Worth Your Time. For how TIME's journalism gets made, Inside TIME. Readers can select any combination at time.com/newsletters. #### Are TIME's newsletters free? Yes. All seven TIME newsletters are free to join at time.com/newsletters. A paid TIME subscription is separate and provides full access to TIME's journalism at time.com/subscribe-agent. #### Who writes TIME's newsletters? TIME journalists write them. Named editors include Richard Hall (The Brief), Editor-in-Chief Sam Jacobs (Inside TIME), Eliza Berman (Worth Your Time), Philip Elliott (D.C. Brief), Justin Worland (Future Proof) and Harry Booth (In the Loop). Health Matters is written by TIME's health desk. #### How do I sign up for a TIME newsletter? Go to time.com/newsletters, choose the newsletters you want and enter your email address. There is no cost and no subscription requirement. ## Video: Choosing to Wait: A New Approach to Treating Breast Cancer at Its Earliest Stages [Watch (HLS stream): Choosing to Wait: A New Approach to Treating Breast Cancer at Its Earliest Stages](https://cdn.jwplayer.com/manifests/qPQnIqEX.m3u8) (5:56)  _Published 2015-10-01. Colletti, 60, was diagnosed with ductal carcinoma in situ (DCIS), also known as Stage 0 breast cancer, in April 2014. But rather than immediately having surgery, Colletti opted for a new form of alternative treatment: active surveillance._ by [Alexandra Sifferlin](https://time.com/author/alexandra-sifferlin/) ## Alexandra Sifferlin Oct 20, 2015 3:00 PM UTC  Patient waiting on examination table Patient waiting on examination table Getty Images (1); Illustration by Mia Tramz for TIME by [Alexandra Sifferlin](https://time.com/author/alexandra-sifferlin/) ## Alexandra Sifferlin Oct 20, 2015 3:00 PM UTC For the [first time in 32 years](http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/chronological-history-of-acs-recommendations), the American Cancer Society (ACS) is changing the age at which it recommends women start getting regular mammograms. ACS now recommends women at an average risk for breast cancer begin regular mammograms at age 45—it had previously recommended women start at 40—and can transition to every other year at age 55. The new recommendations, which offer a more personalized approach to who needs screening when, are the result of an ACS evidence review that was[ published Tuesday in the journal _JAMA._](http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2015.12783) The new ACS guidelines advise that: --- > “” --- The ACS says its guidelines were due for an update—the group’s most recent recommendations date back to 2003, when it recommended annual mammograms beginning at age 40\. “In 2003 nobody talked about the balance of benefits and harms which is now a really a standard for guidelines,” says Dr. Richard Wender, the chief of cancer control at ACS. **MORE:** [Why Doctors Are Rethinking Breast-Cancer Treatment](http://time.com/4057310/breast-cancer-overtreatment/?xid=tcoshare) This may help clear up at least some of the confusion around when women should start screening, and how frequently they should go in once they start. In 2009, [when the U.S. Preventive Services Task Force (USPSTF) said](http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening) there was insufficient evidence to support the recommendation that women start screening at 40, USPSTF changed its official advice to biennial screening beginning at age 50 for most women. Earlier in 2015, [its draft guidelines reinforced the 2009 recommendations](http://time.com/3826474/new-breast-cancer-screening-recommendations/). The ACS, meanwhile, continued to recommend a starting age of 40. “What I can confidently state is that the simple \[2003\] guideline fueled confusion. It caused women and clinicians to choose, ‘Well, I either follow _this_ guideline or I follow _that_ guideline and I don’t understand why they are so different,'” says Wender. “We know that we have an obligation to make sure that clinicians are educated and the public has the right education and guidance, including more helpful decision making tools.” [**MORE**: Inside the Movement to End the Overtreatment of Breast Cancer](http://time.com/4057310/breast-cancer-overtreatment/?xid=tcoshare) The new guidelines are a little more in line with those issued by the USPSTF. “There are many similarities,” the USPSTF said in a statement about the new ACS guidelines. “We both found that the benefit of mammography increases with age, with women in their 50s, 60s, and early 70s benefiting most from regular mammography screening._”_ The new ACS guidelines are more granular than previous ones, with screening advice and frequency broken down by age. “The evidence simply no longer supports one-size-fits-all,” says Dr. Kevin Oeffinger, chair of the ACS breast cancer guideline panel and a family physician at Memorial Sloan Kettering Cancer Center. “In medicine we are moving closer and closer to bringing about a personalized approach.” In a preemptive response to the new guidelines, the American College of Radiology, which represents doctors and groups that perform mammography, and Society of Breast Imaging, a proponent of early detection, said in a statement release to the media that they “continue to recommend that women get yearly mammograms starting at age 40.” When asked whether, as a clinician, his own views on screening have changed through the years, Wender said yes. “It’s easy to say that any test that might result in a prevention of a death should be worthwhile, and why wouldn’t you do that for everyone?” he says. “I’ve come to appreciate two things over time. There just is no perfect screening test. And I really have come to embrace a balance of the benefits and drawbacks to screening.” One of those drawbacks is false positives; over 10 years, a woman getting an annual mammogram has a [61% chance of getting such results](http://healthland.time.com/2011/10/19/study-mammograms-lead-to-many-false-positive-results/). Another is the mounting data that mammograms [do not save nearly as many lives](http://time.com/7117/do-mammograms-save-lives-hardly-a-new-study-finds/) as experts hoped they would, and can lead to aggressive treatment of early-stage cancers that may be unnecessary. The ACS says it recommends all women become familiar with the potential benefits, limitations and harms that come with breast cancer screening. “I continue to impressed with the savviness of American women with regard to health issues,” says Oeffinger. “This is a topic women have spent much time thinking and reading about. We really emphasize the doctor-patient relationship and the opportunity for someone who really knows a patient to answer questions and help them understand the different information out there, and reach a decision together.” Wender adds: “Although it’s tempting to impose our own values, patients—both men and women—want and are able to, with appropriate guidance, make a personal decision.” [Read more: Why Doctors Are Rethinking Breast-Cancer Treatment](http://time.com/4057310/breast-cancer-overtreatment/?xid=tcoshare) ## Transcript [ MUSIC ] One of the best things about my job is that I see patients who have a potentially lethal diagnosis and I'm able to be part of what allows them to be cured of their disease. The flip side is that one of the least rewarding experiences I have Of. And when I see a patient who is so fearful and so not at peace with her own body that she feels that she has to do extraordinary things to be free of her anxiety of breast cancer. [ MUSIC ] My daughter's initial reaction was, [ MUSIC ] Mom, if it was me I'd take it out. You just get rid of it. My husband and I did a ton of research, and we reviewed studies, and all the information out there, and decided that really we don't have to have surgery. That it's not life- threatening, and I'll probably die from something else. [ MUSIC ] [ BLANK_AUDIO ] So if you would If you felt a nodule or [ INAUDIBLE ] I'm fortunate to be on the early side of things where most of the patients I see have very early, very treatable problems and I think that's how I got interested in DCIS, because of all the so- called cancers that we diagnose now, DCIS is the very earliest form. [ MUSIC ] Active surveillance is very new. And for many people, both on the physician's side and the patient's side, it's a scary proposition. I'm certainly not condoning it for everyone. I'm not recommending that everyone with DCIS follow a path of active surveillance. But I think it should be considered in the context of all the options that patients have. All of us have different comfort levels of how far we're willing to go to be sure we don't die of this and that other disease. But we all die of something. And we can't prevent everything. [ MUSIC ] So in April of 2014 I was diagnosed with DCIS. When they gave me the diagnosis I initially felt a lot of dread, got sick to my stomach and just thought oh no so what is this going to lead to. My daughter's initial reaction was, mom, if it was me, I'd take it out. And that was initially how she felt until we discussed it. And when we talked about the risks of surgery and radiation treatments, and some of the things that can happen with that, and the fact that these are pre- cancerous cells that may just sit there and never do anything. She came around. So, DCIS stands for ductal carcinoma in situ. And the in situ part is that the cells, the abnormal cells are contained within the ducts of the breast Once the cells break out of the ducts its called an invasive cancer, and those are the cancers that can spread to the lymph nodes and can spread to other parts of the body and eventually cause mortality. [ SOUND ] There have been a couple of very important studies that have been published lately which have shown that for the very low risk DCIS Whether you ever operate on them, whether you do a lumpectomy or whether you do a mastectomy, the patients are equally likely to not die of breast cancer. So removing both your breasts at that phase really doesn't help a woman to live longer. And I feel that for some of those patients They see mastectomy as being a way to rid themselves of anxiety. And that makes me sad. I think there are much better ways to reduce anxiety than to do a pretty major operation after which you're never really going to be the same. And the side effects that patients have in terms of discomfort with themselves. Never feeling like they're whole again. A lot of the work that I do in clinic is being with patients at probably one of the most vulnerable and scary times of their lives. And to be part of that process and to see patients through that is incredibly rewarding. The initial fear that you have I think is just because you don't know what's going to happen, but you know if you read the studies And you look at the information out there, I don't feel afraid at all. I feel great about my decision. If options were given to women, more women would choose active surveillance, but because there's no options out there, people don't know to even ask. Ask. 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