Erica, the issue of mammos in your 40s is not as simple as do we want to catch the cancer earlier or not? Many mammographic abnormalities in your 40s (and beyond) were likely never going to take one's life or are not cancer, but they result in cost, anxiety, worry, etc. To prevent one death from breast cancer you need to screen over 1,700 40-49 year old women with mammograms! And the benefit in terms of mortality is not seen until they are in their 50s suggesting they would have been "caught" early enough if screened starting at age 50. That's a lot of mammos for little benefit. (For some of the science behind this see this website: http://www.ahrq.gov/clinic/3rduspstf/breastcancer/bcscrnsum1.htm.) People would do well to let go of the inflammatory rhetoric (that I have heard on CNN, local news, etc., not here) and look at the science. I believe that those who are concerned about breast cancer (myself included) should be seeking better screening tests, better treatments and better genetic tests, but not more mammos for young women.

Thanks for your view, CancerDoc! It definitely helps to explain the new recommendation.

As I understand it, in the US women have been having yearly mammograms from the age of 40 and medical knowledge now recognises that in some cases this may be exposing people to too much radiation over the years. Here in France we have excellent health care but mammograms begin at 50 and are every two years. My Dr explained that two years is the ideal period for detecting anything before it gets too big while not overdosing on radiation and possibly causing breast cancer unnecessarily. Anyone with a family history of breast cancer or other breast problems can be screened earlier and more frequently if necessary. My mother died from breast cancer and I was given annual screenings with 4 X-rays taken each time for three years (before the age of 50) but they saw I had no problems and reduced it to the bi-annual regime with 1 X-ray on each side. It's fine I promise you. I'm much happier not having that annual dose!

Mammograms are xrays and are unpleasant and uncomfortable. There are other ways of practising preventative breast health. I've just started a blog on this topic with research links of note and books to read that contextualize the breast cancer industry situation.

At age 40 I scheduled my routine mamogram. I have no family history of cancer and have none of the risk factors. But I went in for the test because the guidelines were for the age of 40. They found an agressive tumor in my left breast. Had I not followed the age 40 guideline, the tumor would have remained undetected until the cancer spread beyond my chest wall and I became symptomatic quite likely rendering in a less treatable diagnosis.....possibly even terminal.

I have four young children and family and friends who love and need me. It is insulting to me that I am considered just an andecdote in the task forces findings.

The American Cancer Society stands behind its recommendation that women begin the screening process at age 40.

I agree with Erica...."an ounce of prevention is worth a pound of cure." Why be reactive when you can be proactive?

Thankfully, I was.

My mother died of breast cancer at 81. Over the years, I've noticed that breast cancer seems to strike older/elderly women far more frequently than it strikes young women. The later mammogram makes better sense to me.

There is a parallel debate that I think should be on the table. I had a NORMAL MAMMOGRAM on June 2009 . Three months later, by doing my SELF BREAST EXAM I FOUND A MASS which turned to be an invasive carcinoma Stage II. I am on chemotherapy now, after a total mastectomy. Mammograms are not the panacea. We need education. How many women know the correct way to make a self exam?. How many OB perform a meticulous mammary exam during the annual screening or are able to teach it to the patients?
As part of my yoga practice I have learned to be respectful of my body needs. But that is not enough for cancer breast. Most women need to be prepared to know basic signs of illness in their body. The self breast exam can save their lives.

I definitely believe that "an ounce of prevention is better than a pound of cure" and that it is always better to be save than sorry. However, I think that whether or not women will continue to get mammograms starting at age 40 or at age 50 really depends on whether or not the insurance companies will continue to pay for the mammograms before the age of 50. I think that is the real danger with this recent announcements. For the most part, women will only get mammograms if they can afford to do so in the first place.

Thank you for this discussion. I'm so pleased to have accidentally stumbled on it today after a visit to my doctor yesterday. I am just 40 and she highly recommended a mammogram even though the recommendations have changed. I do see my gyn as recommended, but I tend to seek out alternative therapy for pretty much everything. I practice yoga, meditation and an Ayurvedic lifestyle. I'm very aware of my body and do self-exam. She kind of scared me a little yesterday and I think it was based in her own fears of having had a sister-in-law pass at the age of 30 from breast cancer.

She did make an interesting comment though. She said that it would simply be nice to have a "base-line" for future mammograms. Any thoughts?

Six years ago I had my baseline mammo at age 40. A large microcalcification cluster was detected (these can not be felt with a self-breast exam, nor was mine felt by three doctors) - it turned out that the biopsy confirmed cancer. I went through mastectomy, chemo, radiation and reconstruction. I am alive today because of early detection and early treatment.

If I had waited? Would I still be here?

I'm 37 years old, over weight and I'm at a higher risk of getting breast cancer, as a matter of a fact I kinda got a breast cancer scare recently when my chest was sore, my nipples were tender and missed my period for a whole month, but was not pregnant. I do have a prescription for a mammo, and will be going in to get tested. This is so scary, but I have to do this, prevention is better than cure and I have a beautiful family and great friends who wants me healthy as so do I.

Thank you for the post and comments. No, it won't change too much for me but in light of the enormous coverage these recommendations are receiving, it's difficult to not think about the questions you pose. In many of the articles I have read, practitioners say that the recommendations should be used as a starting point for deeper conversations between women and their doctors about what makes the most sense for them personally. If that's the case, maybe the start of this conversation will serve as a starting point to re-think many of our clinical practices, including screening - for better or worse. Clearly, screening, like treatment for breast cancer, is not a one-size-fits all endeavor and we shouldn't try to treat the recommendations that way either. Even more, it seems like the point is not to resolve what constitutes "normal screening" and "normal cancer cycles" but rather to reclaim productive tensions as a critical aspect of all life – including health and screening. Furthermore, thinking about what is normal, brings some relief – as well as a reminder – that these are perspectives rather than attributes of individuals and groups. Therefore, it is impossible to understand what "normal screening" means without examining the assumptions that lie below our understandings of health, illness and cancer. These assumptions, like the dominant focus on the disease cancer and not dying from cancer, in general terms become “common sense”. But do these commonsensical assumptions leave room for understandings not based only in standardization but also on what individuals experience and express???

What frightens me about the change in recommendations is the potential for women to believe that they are no longer at risk for breast cancer just because the recommendations have changed. If these changes in recommendations are coupled with a shift in focus to self-examination instead of more invasive techniques, I believe that could be helpful.

This is a wonderful article and thread of comments. Thanks to all the various feelings shared on this topic.

My mother-in-law had breast cancer and a mastectomy and is alive and well now. Therefore, this is a very important topic for me. I also agree that prevention and early detection is SO important! I have several friends who found lumps at ages as early as 22 years old. 40 is definitely a reasonable age to start mammograms. I agree that the teaching level for proper breast exams is really not what it should be.

I think it makes more sense to have a "base-line" mammo at 40 and then follow the doctor's recommendation for how frequently it is needed in the future. Having a base-line can allow for early detection.

Encouraging a healthy diet and exercise is HIGHLY important, and I think most of us who practice yoga and mediation daily also live our lives in a healthy manor such as eating healthy and exercising. Yoga somehow just transforms a person in this way and makes you want to live a healthier life.