Why in News?
The American College of Physicians (ACP) updated its guidance, recommending biennial (every two years) mammograms for average-risk women aged 50 to 74. This has sparked debate, as other major groups still recommend starting at age 40.
Core Function
- Screening Tool: Used for patients with no symptoms to catch cancer up to three years before a lump can be felt.
- Diagnostic Tool: Used to investigate specific symptoms like a lump, pain, nipple discharge, or skin changes.
- Detection: It is the only tool that can reliably detect calcifications, which are often the earliest signs of cancer.
Recent Screening Recommendations (2026)
| Organisation |
Recommended Starting Age |
Frequency |
| ACP (2026) |
50 (40–49 is individual choice) |
Every 2 years |
| USPSTF (2024) |
40 |
Every 2 years |
| ACR & NCCN |
40 |
Every year |
| ACS |
45 (Option to start at 40) |
Annual; Biennial after 55 |
Advanced Technologies
- 3D Mammography (Tomosynthesis): Takes multiple X-rays from different angles to create a "sliced" 3D view. It is more accurate for dense breast tissue.
- AI Integration: AI software now assists radiologists by flagging suspicious areas and predicting a woman’s 5-year cancer risk from a single scan.
- Contrast-Enhanced Mammography (CEM): Uses an iodine-based dye to highlight abnormal blood flow around tumours, similar to an MRI but at a lower cost.
Risks and Limitations
- False Positives: A mammogram may look abnormal when no cancer is present, leading to "call-backs" and unnecessary biopsies.
- False Negatives: Mammograms miss roughly 15%–20% of breast cancers, particularly in very dense breasts.
- Radiation: While it uses radiation, the dose is extremely low and considered safe for regular annual or biennial use.
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