TIME Mental Health/Psychology

Is the Link Between Depression and Serotonin a Myth?

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One in 10 Americans are on an antidepressant, and many are taking SSRIs. But a new report underlines the fact that despite what Big Pharma says, we don’t actually know how they work

Though antidepressants are a common treatment for depression, psychiatrists still don’t have a clear understanding of how exactly they work. A new paper suggests that some explanations persist thanks to clever marketing, despite a lack of scientific evidence.

On Tuesday, David Healy, a professor of psychiatry at Bangor University in Wales and author of Let Them Eat Prozac, published an opinion piece in the journal The BMJ writing that the link between serotonin and depression is a “myth” that continues to be perpetrated by the pharmaceutical industry. Specifically, Healy says the marketing of selective serotonin re-uptake inhibitors—better known as SSRIs—has been problematic.

“Drug companies marketed SSRIs for depression even though they were weaker than older tricyclic antidepressants, and sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety,” he writes. “The approach was an astonishing success, central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance.”

While Healy has been described by some of his peers as an iconoclast, many members of the psychiatry community agree with him. “He’s preaching to the choir at this point,” says Dr. Victor I. Reus, a professor in the department of psychiatry at the University of California, San Francisco.

Reus adds that it’s not that SSRIs don’t work (though there are certainly some who do make that argument). Rather, it’s how they are marketed that is largely overblown. “My experience and belief is that they do work, but we don’t have a comprehensive and holistic understanding of why they work,” he says. “But I think [they] are in many cases remarkably successful even without understanding why they are so.”

MORE Do Depression Drugs Still Need Suicide Warnings?

The idea that SSRIs restore abnormal serotonin levels in the brain isn’t substantiated by research, so why does that line of thinking persist? According to Healy, the idea was adopted by physicians and patients as an easy way to communicate the confounding disorder and its treatment. That’s led to what he calls a costly distraction away from other depression drug research. Meanwhile, many other depression treatments have no effect on serotonin but can be effective against the condition, whereas some people who take SSRIs do not, in fact, get better.

“I think in essence the article raises a point that you have to think beyond SSRIs. They are not industry’s gift for the treatment of depression,” says Dr. Norman Sussman, a professor in the department of psychiatry at New York University Langone Medical Center. Some of the older drugs may actually work better with fewer qualit- of-life-impairing effects.”

Healy does not say that serotonin plays no role in the treatment of depression, writing that the compound is “not irrelevant,” but that the market boom of SSRIs raises questions about why physicians would put aside clinical trial evidence in place of “plausible but mythical” accounts of biology.

“My feeling is that these drugs maybe don’t work as well for depression as they do for other things like obsessiveness and anxiety,” says Sussman. “There are some people that do well on them but most of the evidence that’s come out recently is that they seem to work best in people that are the most depressed.”

Sussman says that SSRIs are often prescribed in primary care for people who have mild depression.

“You wonder what the real risk benefit ratio is in that population,” he says. “They’ve been oversold.”

Read next: Why Kids Who Believe in Something Are Happier and Healthier

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TIME Diet/Nutrition

12 Mental Tricks to Beat Cravings and Lose Weight

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Try the 'apple trick'

Using pure willpower to overcome cravings doesn’t always work. (If it did, dieting would be easy and we’d all be at our own healthy, feel-great weights.) Guess what? You don’t have to tough out an unrelenting yen to house a box of Cheez-Its; you just need to fool yourself into thinking you didn’t actually want to eat the junk food in the first place. It’s easier than you think. Here are tips from experts and recent studies to help you stay on track.

Visualize an internal pause button

The next time you want to reach for a big bowl of Chunky Monkey, picture yourself hitting a pause button in your brain. “If someone were to ask to borrow a lot of money, most people can stop and say, ‘I’ll think about it,'” says Coral Arvon, PhD, director of behavioral health and wellness at Pritikin Longevity in Miami, FL. But when that chocolate cake or bottle of wine is in front of us at the end of day, the majority of us don’t hesitate to indulge. “Think ‘pause,’ and consider your decision for 10 minutes before making an actual decision,” Arvon suggests.

Watch the video: 6 Ways to Trick Yourself Into Eating Less

Substitute junk food with healthy foods that resemble junk food

Find a healthy alternative that shares some of the same qualities as the fatty food you’ve got a craving for, says Jonathan Alpert, a New York City-based psychotherapist and author of Be Fearless: Change Your Life in 28 Days. Craving the crunch and salt of potato chips? Make a batch of satisfyingly crispy kale chips. Eyeing the carton of ice cream in your freezer? Whip up a fruit-packed smoothie bowl instead. “Over time your taste buds and brain will adjust and learn to like these healthier options,” says Alpert.

Watch the video: 5 Healthy Baking Swaps

Imagine yourself eating

Thinking about eating a bag of candy makes it more likely you’ll eat less of it when you actually start eating it, according to a 2010 study by Carnegie Mellon University researchers. Study participants who visualized eating 30 M&Ms before indulging in a bowl of the candies ate fewer M&Ms than two other groups who imagined eating only three candies or no treats at all. Researchers say the key lies in thinking about eating the food versus merely thinking about or visualizing it.

Tell yourself you can have anything

When you think about going on a diet, hunger pangs, deprivation, and waving goodbye to your favorite foods probably come to mind. Problem is, denying yourself your favorite foods immediately sets you up for failure, says Amy Goodson, RD, sports dietitian for the Dallas Cowboys and co-author of Swim, Bike, Run, Eat: The Complete Guide to Fueling Your Triathlon. “You want to make changes you can do for the rest of your life. The key is to eat what you want, but not everything you want,” says Goodson. “You can still enjoy one to two splurges during the week as long as you stay on track the rest of the time.”

Read more: 10 Mistakes That Make Cravings Worse

Go back in time

Cut back on calories by learning to snack like a preschooler, says Goodson. “Many people get in trouble with snacking because they eat too much. So trick your mind into eating less by portioning your snacks in small baggies. This helps you feel as if you’re eating ‘all’ of something, which satisfies your brain.” Ideally, break out portion sizes of chips, snacks, and other goodies as soon as you bring them home from the store so you’re not tempted to dip your hand in the entire 10-serving container. To further avoid temptation, keep the portioned snacks out of sight hidden in a cupboard.

Read more: A Slacker’s Guide to Losing Weight Without Trying

Use the “apple trick”

The next time you’re standing in front of the refrigerator trying to figure out what you’re craving, maybe you’re not really hungry, says Goodson. Here’s how to figure out if you’re genuinely hungry or just trying to satisfy a craving. “When you crave a salty or sweet treat, ask yourself if you’d eat an apple,” says Goodson. “If the answer is yes, you’re hungry and it’s okay to have a small snack. If not, drink some water, because you’re not really hungry.” Since thirst often masquerades as hunger, drinking a glass of water should silence your craving.

Watch the video: 4 Tricks to Eat Healthier

Plan your junk food

Instead of waiting for a temptation to strike and only then trying to handle it, plan to have one indulgent or “junk” food a day, preferably after dinner, says Judith S. Beck, Ph.D., president of the Beck Institute for Cognitive Behavior Therapy in Philadelphia and clinical associate professor of psychology in psychiatry at the University of Pennsylvania. “It’s easier to resist cravings during the day if you know you are going to have your favorite food that night.” And when you finish a moderate portion of that food, remind yourself that if you want more, you can have more tomorrow night, and the next night, and the next night, and so on.

Create a top 10 list of distractions

Before a craving strikes, be ready to combat it by having a ready list of alternative activities to keep you on the straight and narrow. “Play a video game, call a friend, take a walk, read to your kids, groom your dog, polish your nails,” says Beck. “Watch how the craving has diminished when you firmly focus your mind on something else.” Other distractions include brushing your teeth, doing a set of crunches or push-ups, deep breathing, or meditation.

Read more: 20 Little Ways to Drop the Pounds and Keep Them Off

Fool your eye

Use smaller plates. A moderate portion on a large dinner plate looks small, says Beck. “Part of feeling satisfied is visual satisfaction. Another part of feeling satisfied is when hunger diminishes. So pledge to eat all your food sitting down, slowly, while enjoying every bite.” Keeping junk food out of sight and eating in only the kitchen or dining room—not in front of the TV—can also help you lose weight, according to a Cornell University study.

Read more: 10 Signs Your House Is Making You Fat

Train your resistance muscle

Every time you have a craving and you resist it, you build up your “resistance muscle,” which makes it more likely that the next time you have a craving you’ll resist it. On the other hand, each time you give in to a craving, you strengthen your “giving in muscle,” says Beck, “which makes it more likely that the next time you’ll give in and the time after that and the time after that.”

Set your phone to send you motivational messages

Spontaneous eating is what gets almost every dieter into trouble, says Beck. One way to counteract it is by turning your phone into your conscience. She suggests setting a reminder on your smartphone so every time it goes off, you read a message that encourages you to stick to your diet: “I could eat whatever I want, OR I can lose weight and be healthier,” or “If I eat food I haven’t planned to eat I’ll get momentary satisfaction but I’ll feel bad later.” You’ll want to have these ideas at the forefront of your mind every time you’re hit with a craving.

Read more: How the Pros Curb Food Cravings

Stay clear of TV while eating

Turn off The Walking Dead while eating dinner and you’ll eat fewer calories. Watching TV makes you overeat, according to a study published in the journal Appetite. Two groups of women were studied while they snacked with or without TV. One group was offered one type of snack, while the other group had the choice of four snacks. Everyone ate more while watching the tube. “Avoid this by never having the box or bag of snacks next to you while watching TV,” says Goodson. Get a serving on a napkin or small plate and take the serving to the TV room.

This article originally appeared on Health.com.

TIME medicine

Vaccines Don’t Cause Autism, Even in Kids at Higher Risk

"We are able to look at the vaccines and show there is no association with autism"

In the latest study on the vaccines, researchers find even more evidence that childhood immunizations aren’t linked to autism.

In a study published in the Journal of the American Medical Association, a group led by Dr. Anjali Jain of the Lewin Group, a health care consulting organization, found that brothers and sisters of children with autism were not at any higher risk of developing the disorder if they were vaccinated compared with brothers and sisters of those without autism.

Numerous studies have found an increased risk of autism among those with older siblings with the condition, and some parents who believe that their older child’s autism is connected to vaccinations, specifically the MMR vaccine, have been reluctant to immunize their younger children. Indeed, Jain found that vaccination rates among siblings of autistic children were lower, at about 86% at 5 years, compared with 92% among those without autistic brothers or sisters.

But among the 95,000 children with older siblings included in the study, children who received the MMR and had autistic older siblings were no more likely to develop autism than children who were vaccinated and didn’t have any autistic older siblings. In fact, the relative risk of autism among those with older autistic brothers or sisters was lower if they were vaccinated compared with those who were not vaccinated.

“Our study confirmed that in kids with older siblings who we know are at increased risk of developing autism themselves, those kids are being vaccinated less,” says Jain. “But in the kids who did develop autism who were vaccinated, there was no increased risk from the vaccine compared to kids who did not get the vaccine.”

The results, she says, should put to rest any concerns that parents of autistic children might have that vaccinating their younger kids will somehow increase their risk of developing autism. The large size of the study, and the fact that vaccination and autism information wasn’t collected for purposes of a vaccines-and-autism study but as part of a larger health insurance database, also reinforce the strength of the findings. (The Lewin Group is an editorially independent part of Optum company, which collected the data.)

“We may not understand what is causing autism in these kids or families,” says Jain. “There could be a host of both genetic and environmental factors. But we are able to look at the vaccines themselves and show there is no association with autism.”

Read next: HPV Vaccine May Work for People Who Already Had the Virus

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TIME Infectious Disease

HPV Vaccine May Work For People Who Already Had the Virus

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Elizabeth Renstrom for TIME

A new study underlines the effectiveness of the HPV vaccine, showing the vaccine is protective against the virus on multiple sites on the body, even for women who have been infected in the past.

In a randomized controlled trial—considered the gold standard of scientific research—scientists wanted to know if the HPV vaccine protected against cervical, anal and oral HPV. Daniel C. Beachler, a postdoctoral fellow in the Infections and Immunoepidemiology Branch of the National Cancer Institute (NCI), and his colleagues followed 4,186 women between the ages of 18 to 25 who were either vaccinated with a HPV16/18 vaccine or a control vaccine (a hepatitis A vaccine). Cervical samples from the women were collected at their annual visits and oral and anal samples were collected at a four-year follow-up visit.

“We were interested in the question of whether the vaccination may protect non-infected sites against HPV infection or re-infection in women who were previously exposed to HPV prior to vaccination,” says Beachler. The study was presented at the American Association for Cancer Research annual meeting.

The results showed that the efficacy for the vaccine in all three sites was 83% among the women with no evidence of prior HPV exposure and infection, 58% among women with prior HPV exposure, and a 25% among women with active cervical HPV16/18 infection (the percentage was considered nonsignificant). In total, the researchers report that the overall vaccine efficacy was 65% for all sites and 91% for protection in at least two sites.

Among the women in the trial, some had no evidence of HPV, some had an active HPV infection, and some of the women did not have an active infection but had antibodies for HPV, suggesting that they had been exposed to the virus previously. That’s not uncommon, considering the U.S. Centers for Disease Control and Prevention (CDC) estimates that nearly all sexually active men and women get HPV at some point in their lives.

The CDC says teen boys and girls who did not start or finish the HPV vaccine series when they were younger should get it, and young women can get the vaccine through age 26 and young men through age 21.

The CDC says that girls who are already sexually active can still benefit from the vaccine, but it may be less effective since it’s possible they have already been exposed to one or more HPV strains. Still, the CDC says that since young women are not necessarily infected with all types of HPV, they can still benefit from the vaccine. This new study underscores that guidance.

“[This study] is supportive that there could be some benefit at these older ages,” says Beachler. “Close to 90% of individuals are able to clear an HPV infection on their own. This is not a therapeutic vaccine but it could still help protect from acquisition of new infections.”

Dr. Miriam Lango, a head and neck cancer surgeon at Fox Chase Cancer Center, says that the new study is some of the “best kind of evidence we have,” in support of vaccinating against HPV in women of that age. “My understanding was always that you get the vaccination before you get the infection and that after you’ve been infected there’s no benefit to having the vaccination,” she says. “That’s really not what the data tells us.” Lango was not involved in the study.

Beachler noted that at the end of the study, the women in the control arm of the trial were able to get vaccinated against HPV.

TIME Cancer

New Genetic Test for Breast Cancer Would Be Cheaper and Easier

color-kit-breast-cancer
Color Genomics Saliva test kit offered by Color Genomics

The test would cost just $249

A startup is developing a cheaper, easier way of determining whether women are genetically at risk for breast cancer, in a move that could revolutionize the way women are currently screened for the disease.

Currently, genetic testing for breast cancer risk is expensive and usually reserved for women who have a family history of the disease. But the startup Color Genomics is offering a saliva test that would cost only $249, about one-tenth the cost of many other genetic screens for breast cancer, the New York Times reports.

The saliva test analyzes BRCA1 and BRCA2, the two primary genes where mutations increase breast cancer risk, along with 17 other genes. Elad Gil, chief executive of Color Genomics, said he wants to “democratize access to genetic testing” and that the low cost of the saliva test means women could pay out of pocket if their insurance company did not cover the test.

Still, there are concerns. Some experts worry that the low cost of the test may not include a full analysis, and others raised concerns that greatly expanding the number of women tested could create confusion for those whose test results are unclear.

[The New York Times]

TIME celebrities

Roseanne Barr Talks Candidly About Going Blind

Roseanne Barr
Grant Lamos—Getty Images Roseanne Barr attends the world premiere of documentary: 'Roseanne For President!' during the 2015 Tribeca Film Festival at SVA Theatre on April 18, 2015 in New York City. (Photo by Grant Lamos IV/Getty Images for the 2015 Tribeca Film Festival)

"I just try and enjoy vision as much as possible"

Roseanne Barr offered a frank assessment of how she was coping with her deteriorating eyesight, saying in an interview on Monday that she expected to go blind as a result of macular degeneration and glaucoma.

The comedian said in an interview with The Daily Beast that she used marijuana to relieve the feeling of pressure in her eyes, but her symptoms were steadily worsening.

“My vision is closing in now,” Barr said. “That one’s harsh, ’cause I read a lot, and then I thought, ‘Well, I guess I could hire somebody to read for me and read to me.’ But I like words and I like looking. You do what you have to do.”

“I just try and enjoy vision as much as possible,” she added, “y’know, living it up.”

Read the full interview at The Daily Beast.

Read next: Uber to Face Lawsuit Claiming Discrimination Against the Blind

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TIME medicine

This Is a Baby’s Brain on Pain

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For the first time, scientists map newborn babies’ brains on pain, and the results are surprising

In a first, researchers at Oxford University have watched infants as young as a day old as their brains process a light prodding of their feet. The results confirm that yes, babies do indeed feel pain, and that they process it similarly to adults. Until as recently as the 1980s, researchers assumed newborns did not have fully developed pain receptors, and believed that any responses babies had to pokes or pricks were merely muscular reactions. But new research published Tuesday morning changes that.

Taking advantage of the fact that newborns less than a week old tend to sleep through anything, Rebeccah Slater, an associate professor of pediatric neuroimaging at Oxford, and her colleagues placed 10 infants who were 1-6 days old in an fMRI machine. The researchers, who reported their findings in eLife, observed which areas of the infants’ brains became more active, or consumed more oxygen, as the scientists lightly poked their feet. They did the same for adults and compared the brain images.

In adult brains, 20 regions were activated by the painful stimulus, and the newborns shared 18 of these. “The infant’s brain is much more developed than I was expecting,” says Slater. “I might have thought that some information might have gone to the sensory areas of the brain — telling the baby something was happening on the foot, for example — but I didn’t necessarily think it would go to areas more commonly involved in emotional processing such as the anterior cingular cortex, which is thought be involved in the unpleasantness associated with an experience.”

Even at birth, then, a baby’s brain possesses the foundation for quickly evaluating anything he or she experiences, including painful stimuli. “I hope this provides incentive to more researchers to find better ways of measuring pain in babies, and prioritize the importance of providing the best pain relief possible in children,” says Slater.

Slater found that newborn brains are still immature in some ways, however. Any stimulus, whether it’s a painful one or a sensory one such as a smell, tends to activate widespread regions of the brain. That signals that the baby’s brain is still trying to learn what’s what and distinguish different stimuli. The poking triggered even the newborns’ olfactory system, for example, even though the sensation had nothing to do with smell.

Second, babies tend to register all stimuli as having the same intensity. Even light pokes “feel” the same as harder ones, reflecting their still inexperienced system in distinguishing levels of activation.

But the fact that they are experiencing pain in almost the same ways as adults do is very revealing. Now that there’s evidence that the brains of babies do indeed process pain, that may change the way doctors treat newborns, especially those who are premature or need extra medical attention in the neonatal intensive care unit. In a recent study, scientists tallied an average of a dozen procedures including needle sticks that babies experienced every day; more than 60% of those infants did not receive any pain medication, either in the form of a topical numbing cream or other pain relief. Having these experiences may make these babies more sensitive to pain later in life, says Slater. A study of circumcised baby boys, for example, found that those who received pain relief felt less pain when getting vaccinations three months later than those who didn’t receive any pain medication.

“Now that we have seen for the first time what is happening in babies’ brains while they experience something mildly painful,” says Slater, “there should be a big drive to try to treat pain in these children, especially those having a high number of procedures performed in their early days.”

TIME Diet/Nutrition

Kraft Mac & Cheese Plans to Go for a More Natural Look

The change is expected to go into effect in January 2016

Your bowls of Kraft mac & cheese could look a bit different starting next year.

Kraft Foods Group will no longer use synthetic coloring or artificial preservatives in its original Macaroni & Cheese in the U.S., the company announced Monday, and it will also remove synthetic coloring from Kraft Dinner Original meals in Canada.

Customers have long identified the pasta dish with the iconic orange color, but the manufacturer says it will turn to natural color alternatives derived from sources like turmeric, paprika and annatto.

The company’s announcement called the move an “on-trend update” to the brand and explained that customers “want to feel good about the foods they eat and serve their families, including everything from improved nutrition to simpler ingredients.”

The change is scheduled to come into effect in the U.S. in January 2016.

TIME Diet/Nutrition

Eating Insects Isn’t as Eco-Friendly As People Say

Insects: Our Food Of The Future?
Sean Gallup—Getty Images Dried grasshoppers, mealworms and crickets seasoned with spices

Crickets aren't so green after all

Crickets are often trumpeted as the future of food, an edible, eco-friendly solution to a some-day protein shortage that livestock just can’t fix. Even the United Nations promotes insect-eating as a promising, protein-packed way to feed the 9 billion people that will live on earth in 2050. “A benefit of insects as an alternative animal protein source is that they can be reared sustainably on organic side streams (e.g. manure, pig slurry and compost),” their report reads.

Because insects emit far fewer greenhouse gases than livestock and consume way less water, they have a comparatively tiny ecological footprint, and they’re thought to thrive on basically anything, even organic waste. That last point sums up the main ecological appeal of eating insects; growing the grain used in animal feed takes up huge water and energy resources.

But do crickets really have the potential to be the new beef? Not yet, according to a new study published in the journal PLOS ONE. When researchers raised crickets on several different diets and tried to see how much protein they could squeeze out of them, they got some disappointing results: just not a whole lot of protein.

MORE: Why, On Second Thought, Maybe You Shouldn’t Start Eating Bugs

In the experiment, researchers raised crickets on one of five different diets. They replicated each diet three time and harvested the crickets after two weeks. One group ate corn-, soy- and grain-based feed, while others survived on food waste or crop residue. The researchers measured how big the crickets grew and how much edible protein they produced.

Diet made a huge difference, the study authors found. Those that ate a diet of processed food waste had a feed and protein conversion rates no more efficient than that of chickens. Nearly all those fed straight food waste died before they could be harvested. And the most successful crickets were those that ate a grain-based diet similar to what most poultry eat. They had a 35% protein conversion rate, which is only slightly better than chickens.

So even if the whole world took a page out of Mexico’s cookbook and developed an appetite for chapulines—crunchy fried crickets—the small protein payoffs may not even be worth it if we’re feeding them what chickens eat, the authors suggest.

“I think the sustainability claims on this topic have been overstated given the current state of knowledge,” wrote study author Dr. Mark Lundy of the University of California Division of Agriculture and Natural Resources in an e-mail.

Even if they can’t survive on as many organic sidestreams as we originally thought, Lundy doesn’t think that insects are out of the running as the future of food.

“I’m all for exploring alternatives, and I am impressed by the amount of innovation that has sprung up around insect cultivation and cuisine in the last few years,” he says. “However, I also think we need to be clear-eyed about what the sustainability gains are and aren’t, and focus our innovative efforts and limited resources to where they will have the most lasting impact.”

Swapping chickens for crickets–while feeding them the same thing—is unlikely to make a real difference. “Insect cultivation is more likely to contribute to human nutrition at a scale of economic and ecological significance if it does not rely on a diet that competes with conventional livestock,” he says, “but more innovation is needed for this to become a reality.”

TIME Cancer

Most Women Should Not Get Yearly Mammograms, Group Says

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A U.S. panel of experts reaffirms its recommendations

Six years ago, the U.S. Preventive Services Task Force (USPSTF) caused a stir when it changed long-held breast-cancer-screening recommendations and advised women to wait until age 50 rather than 40 to start getting mammograms. The task force also said women should do it every other year, and women under age 50 were told that the choice to get mammograms at their age was an individual one.

In the intervening years, that’s become a less controversial opinion, partially because of growing evidence that too much screening can lead to anxiety-ridden false-positive results, overdiagnosis and overtreatment. On Monday, the USPSTF released its updated recommendations, which look very similar to the recommendations released in 2009.

The new draft guidelines suggest women ages 50 to 74 get a mammogram every two years and women ages 40 to 49 should make their own decision on whether to start screening in consultation with their doctors. The task force also concluded that there was not enough evidence to make a recommendation for or against mammograms for women ages 75 and older, 3-D mammography or additional screening besides mammograms for women who have dense breasts. The guidelines will now undergo a public commenting period, and you can send in comments here.

“In 2009, to suggest that mammography has limitations and that it has harms and that we need to look at the balance was not the way most people were thinking about it,” says Dr. Michael L. LeFevre, past chair of the USPSTF. “Much has been written about mammography in the last five years. I think people understand that it is a good test, it’s not a perfect test, and that there may be some significant harms associated with it.”

The task force added a nuance in the new guidelines that highlights which women might want to consider mammography more strongly, saying women in their 40s who have had a mother, sister or daughter with breast cancer are at a higher risk, and may benefit from mammography at a younger age than women who are at an average risk.

MORE: Diagnosed With Breast Cancer? Get a Second Opinion

In the past year, there’s been compelling evidence in support of the 3-D mammogram as an accurate — and perhaps better — screening tool. One June study showed 3-D mammograms can pick up more breast cancers and lead to fewer callbacks for more testing than 2-D mammography. LeFevre says that while it’s a promising technology, he doesn’t think there is enough evidence to prove if it will result in improved health. “We are going to have to see more than just detection. There have to be more studies that look specifically at the outcomes in order for us to be certain,” he says.

Despite the fact that the mammogram recommendations happened over six years ago, many doctors still insist on yearly mammograms for their patients over age 40. The American Cancer Society also continues to recommend that women age 40 and up get yearly mammograms.

“There are plenty of women in the position with people just telling them you need to have a mammogram every year. I am somewhat embarrassed to admit that is still going on,” says LeFevre. “On the other hand, I think women are being more proactive about their discussions of mammography, and I think that’s reflective of the environment change we are in.”

The task-force guidelines are intended for women ages 40 and up who do not show signs of breast cancer, have never had breast cancer and do not have risk factors like a genetic mutation that put them at higher risk. High-risk patients should consult with their doctor for an individualized screening plan.

“Mammography helps. We can reduce women’s likelihood of dying of breast cancer by undergoing some regular screening at some interval during certain ages. That’s a common theme across almost all organizations that look at this,” says LeFevre. “We think we should be doing it in a way where we maximize the balance of benefits and harms. That’s our topline message and that’s what I hope women hear.”

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