When the Channel Seven breakfast presenter recently urged women to start breast screening at 40 years, ignoring vast amounts of independent medical research about the downsides of cancer screening tests if undertaken outside recommended times or situations, she was possibly hoping to save lives. She then underwent a mammogram at 41years of age ( outside the BreastScreen's targeted starting age of 50 years) , was called back for further testing, experienced the anxiety of waiting for test results, before being given the all-clear. The programme demonstrated, but failed to discuss the risks of screening and well as benefits, which would have encouraged women viewers to make informed decisions about whether to be screened.

Screening women in their 40's may reduce the risk of dying from breast cancer by a small amount, most of the benefit of screening occurs in women aged 50-74years. The chance of a false alarm as experienced by the TV host, with biopsies required and the anxiety  and emotional distress associated  is higher for women in their 40s. Screening healthy women in their 40s is more likely to harm than save lives.

It is true that one in eight women in Australia will develop breast cancer in their lifetime and it is best to detect early to improve your chance of survival. There are over 120 000 screening mammograms provided by BreastScreen to Western Australians each year. Over 75% of breast cancers occur in women over 50 years of age, the risk of breast cancer increases with age.

It may be appropriate for women to commence screening at 40 years, those who have a first degree relative (such as mother or sister) with breast cancer diagnosed before the age of 50 years, or a first degree relative with cancer in both breasts at any age, of two or more first degree relatives with breast cancer diagnosed at any age. In such situations the recommendation in to undertake annual screening from the age of 40 years.

If your decision is not to undertake regular screening in your 40s and wait until 50 years, you must still remain alert to changes in your breasts and seek the advice of your GP about appropriate management. You can also take preventative steps to reduce your chance of developing breast cancer by regularly exercising, controlling your weight and reducing your alcohol intake.

For further overview information see , or for an excellent discussion regarding over-diagnosis of breast cancer from screening mammogram.

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