Why Black Women Should Still Get a Mammogram Starting at Age 40, Not 50

New federal guidelines recommending mammograms at age 50 have alarmed breast-cancer activists, who say African-American women are at higher risk at a younger age and for more-aggressive forms of cancer.

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In April, the United States Preventive Services Task Force proposed new breast-cancer screening guidelines that advise women to get their first mammogram, the test that screens for breast cancer, at age 50 and then once every two years thereafter.

These recommendations are at odds with long-standing advice from organizations like the American Cancer Society, the American College of Obstetricians and Gynecologists, the Black Women’s Health Imperative and the Susan G. Komen organization—all of which recommend that women at average risk obtain their first mammogram at 40, followed by one mammogram each year afterward.

The task force recommends that 40-something women discuss their need for mammograms with their doctor. But many experts believe that waiting until 50 for a mammogram is dangerous.

“The recommendations may cause women under 50 to delay paying attention to their breast health and breast-cancer risk,” said Komen President and CEO Dr. Judith A. Salerno in a press release.

“Anytime scientists can’t or don’t agree, it gives some men and women an excuse not to do something that could very well save their lives,” says Linda Goler Blount, president and CEO of the Black Women’s Health Imperative, a Washington, D.C.-based health-advocacy organization. “As a very good friend said, ‘If the scientists can’t agree on when I should have a mammogram, then why should I have a mammogram?’”

Troublesome Advice for Younger Black Women

Early detection of breast cancer saves lives among all women, but particularly black women, who are 10 percent less likely to develop breast cancer than white women but 40 percent more likely to die of it, in part because black women are 45 percent less likely to have health insurance, plus are less likely to be diagnosed early, when more treatment choices exist and they are more effective.

Black women are also more likely to develop a very aggressive strain, triple-negative breast cancer, at a young age. “Younger black women get breast cancer at higher rates and five to seven years younger than white women,” says Blount. For example, it’s not uncommon for black women to develop breast cancer in their 30s.

Half of black women (pdf) are diagnosed before age 57 and half after, compared with age 62 for white women.

Because the task force advises the government, many health advocates—including breast-cancer survivor Rep. Debbie Wasserman Schultz of Florida, who found a lump in her breast at age 41—fear that if its guidelines take hold, health insurers may not cover the full cost of mammograms for women under 50.

Stressed vs. Dead

Experts try to balance the benefits of tests with the harm the tests may cause. For example, mammograms that yield a false-positive result can stress women out and lead to breast biopsies and other unnecessary tests that can be painful and even jeopardize their lives.