Recommendations for the age to start routine mammograms vary significantly among different health groups. While some suggest starting at age 40, others advocate a start at age 50. These discrepancies reflect the need to consider individual risk rather than applying a standard approach.

Experts emphasize that the risk of developing breast cancer is not the same for all women. Factors such as genetics and age are determining factors.

Dr. Laura Esserman of the University of California, San Francisco, told the Associated Press (AP) the need to personalize screening recommendations, since breast cancer manifests itself in a variety of ways.

"Breast cancer is not a single disease. So how is it possible that all people undergo the same screening tests when not everyone has the same risk?" he warns.

Debate around detection

According to the American Cancer Society, more than 320,000 women in the United States will be diagnosed with breast cancer this year.

The new guideline from the American College of Physicians suggests mammograms every two years for women ages 50 to 74, which contrasts with other organizations that recommend annual mammograms starting at age 45.

This disagreement highlights the complexity of the guidelines and the importance of considering the pros and cons of each approach.

Advances in detection

Ongoing research includes broader genetic testing and the use of advanced technologies such as digital breast tomography.

Previous studies indicate that risk-based approaches are as effective as conventional annual mammograms, opening the door to new guidelines that could be better tailored to women's needs.

It is noted that mortality rates have been declining for decades, thanks in large part to better treatments. However, it remains the second most common cause of cancer death in American women, and diagnoses are gradually increasing.

Alternatives to mammograms

Mammography remains the best test for the early detection of breast cancer, but there are important alternatives or complements depending on the clinical case. These are the main options: Breast ultrasound. Dense breasts, to distinguish cysts from solid tumors. Without radiation, it is safe. Although it may not detect microcalcifications

Mammography with contrast. Not recommended for those who suffer from claustrophobia and allergies to gadolinium. It is less expensive than MRI. Requires intravenous contrast

Digital tomosynthesis (3D mammography). Improved routine detection. Shows tissue more clearly than 2D mammography. It's a mammogram, but more advanced.

Breast self-examination. Monthly monitoring from the age of 20. No cost. It does not replace medical tests, it only detects obvious changes.

Key points: Ultrasound is the most common complement for women with dense breasts. MRI is reserved for high-risk women (vital risk > 20%, BRCA mutations, etc.). 3D tomosynthesis is the evolution of conventional mammography with better precision.

The choice depends on your age, breast density, family history and risk level. Consult your doctor to determine which combination of tests is right for you.

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