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New guidelines from the American College of Physicians indicate at what age mammograms should be sta

Can mammograms cause damage?

The goal of screening mammography (such as self-examination) is to detect tumors earlier, when it is easier to treat. Ideally, this should mean that fewer women are diagnosed when tumors are larger, grow quickly and are more difficult to attack.

However, the harms of an excessive screening test may include unnecessary invasive follow-up tests and treatments for cancer of tumors that have never progressed or led to death, which is also known as overdiagnosis.

And although mammography is not a surgical intervention or involves pain, it can cause some drawbacks: false positives, overtreatment and excessive radiation. Then, could it be useless - and even dangerous - to undergo screening for breast cancer?

Breast cancer is more common as women get older and some of the harms of screening tests, such as false positives, are less frequent in older women, which causes the benefit to increase and the damage to be reduced to as women get older.

Because of this, evaluation is beginning to be recommended from the 1950s onwards. Thus, for most women between the ages of 40 and 49, the potential harms of screening mammograms outweigh the possible benefits, in accordance with the guidelines of the American College of Physicians.

his overdiagnosis triggers a whole protocol of useless treatment in women who enjoy good health: lumpectomy (surgical removal) or even mastectomy (amputation of the breast), radiation (radiotherapy), chemotherapy ... with everything that implies in terms of pain, risks, side effects (increased risk of death from cancer or heart disease) and psychological traumas. In many cases in vain.

Once women begin to have mammograms, they should continue until the age of 74, age at which they should be interrupted in those in which they have a life expectancy of 10 years or less.

That is to say, screening should be done every two years in women between 50 and 74 years of age, since the largest incidence of this tumor is located after the decay. This is precisely the protocol that is indicated in Spain, where, according to Europe, it begins with the periodic screening at 50, except for some autonomies where it is ahead of 45, such as the Community of Valencia, Navarra and Castilla-La Mancha; despite the fact that "there is no scientific evidence" to advance the first revision.

Moreover, research published in the National Cancer Institute magazine concluded that screening mammography is not useful for women under 40 years of age and their possible damages could outweigh the benefits. It is not only the worry and anguish that a 'false positive' result can generate, but also the potential damage caused by radiation and the rest of invasive and unnecessary tests.

However, experts say that in all cases it is not, and that when a woman gives a false positive, especially in the recommended age range for regular mammograms, the case must be analyzed.

In what there is no doubt is in the case of having a family history; in this scenario, the first control should be done 10 years before the age at which the relative had breast cancer.

"It is important that all women talk to their doctor, starting at age 40, discuss the benefits and harms, share their individual values and preferences, and actively participate in the discussion and decision on when to start the screening test. of breast cancer that would be the best ", conclude the experts of the American School.

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