Why I’m Ignoring the New ACP Mammogram Guidelines
The American College of Physicians (ACP) just released new breast cancer screening recommendations — and I’m ignoring them. They don’t take into consideration the latest research, they fail to acknowledge that rates of breast cancer are increasing among younger women, and frankly, had I followed guidelines like these, my DCIS may never have been detected.
Here are the basics of their “recommendations”:
- Mammograms every other year starting at 50 and ending at 75, for average-risk women
- No recommendation for supplemental screening
- An overly paternalistic stance on the “risks” of overdiagnosis
Why This Is Personal
This hits me on a personal level. I wasn’t at high risk of getting breast cancer. And yet, I got DCIS at 41. Had I followed these guidelines, I may never have gotten those mammograms at 40 and 41. Because I did, I was able to choose the surgery that was right for me. My cancer was caught early. It was more treatable.
I am disappointed in these recommendations, and I urge you to ignore them. I’ve included some links below to help you sort through the noise and make your own informed decisions.
What the Experts Are Actually Saying
There are many well-researched statements coming out that directly address and support annual mammography beginning at 40 — with additional guidance on risk assessments beginning at age 25.
Here are a few:
American College of Radiology (ACR) and the Society of Breast Imaging (SBI) released a statement noting that the new ACP guidelines “rely on outdated and hyperbolic information, will cause continued confusion among women and may contribute to thousands of additional breast cancer deaths each year.” Read the full statement here.
NCCN continues to recommend annual screening mammography beginning at age 40 for average-risk women, stating: “Mammographic screening and subsequent treatment based on those results reduces breast cancer mortality based on a wide range of studies using various methodologies.” Read the full statement here.
ASBrS (American Society of Breast Surgeons) also supports annual screening beginning at 40, with a risk assessment starting at 25. Read the full statement here.
A Promising Step Forward: AI-Enhanced Screening
In addition, the NCCN recently recommended that all women get a baseline mammogram — enhanced with AI — starting at age 35. The platform is called Clairity Breast, and while it is not yet widely available, this is a promising advance in AI-assisted screening. Read more here.
The Bottom Line
If I had followed the ACP’s recommendations, my DCIS would not have been detected. I may not have had the choices I had. These “recommendations” are based on outdated research and — as the ACR and SBI say — may cost lives.
My take: I’m ignoring them. And I hope you do too.
An Open Letter
Dear American College of Physicians:
Stop confusing women. Do better research. Rewrite your guidelines.
The experts have spoken — and we disagree.
With much annoyance,
The Breast Cancer Community
Jennifer Douglas
Jennifer Douglas is an author, patient advocate, and DCIS breast cancer survivor. After navigating her own breast cancer journey in 2019, she began writing and encouraging others who were newly diagnosed. Her resources include her book, "A Breast Cancer Journey: Living It One Step at a Time," and her online support course, "Encourage: Breast Cancer and Beyond." Jennifer also actively supports patients through her online presence and direct involvement in communities and support groups, offering guidance and encouragement every step of the way.
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