October is breast cancer awareness month and new breast cancer screening recommendations from the American Cancer Society are in the spotlight.

Most women have been told they need to get mammograms starting at age 40, do a monthly breast exam on themselves and get a yearly exam by their physician.

But the American Cancer Society came out with new recommendations that are getting a lot of attention, and raising a lot of questions.

The American Cancer Society issued new controversial recommendations for women at average risk of breast cancer.

It recommends:

  • Women ages 40 to 44 should have the choice to start annual  mammograms
  • Women age 45 to 54 should get mammograms every year
  • Women age 55 and older should switch to mammograms every two years, or have the choice to continue yearly screening

“It’s all based on chances of getting breast cancer, and chances of finding breast cancer on a mammogram and is that going to save a life,” said Dr. Josette Spotts, breast surgeon.

She says the new recommendations take many factors into consideration but patients and their doctors need to discuss all options.

“To me, or the majority of breast surgeons, or anybody who deals with breast cancer patients, are still going to go by their recommendations that we’ve had for many years that starting at the age of 40 and at least a clinical breast examination annually,” Dr. Spotts said.

She strongly objects to new recommendations suggesting there is no benefit to a physical breast exam either monthly by you or annually by a doctor.

“I absolutely disagree with their recommendation of not doing at least doing a physician clinical breast examination on a patient every year because I have seen many patients come in with a normal mammogram and they come in for their routine annual follow up and I do a breast exam and they have an abnormality that wasn’t seen on their mammogram,” Dr. Spotts said.

She also says patients need to be aware of changes including spontaneous, persistent, bloody discharge from the nipples or a rash on the breast or areola or lumps in the breast or nearby.

“Lumps under the arm could signify a cancer that has already spread to the lymph nodes under the arms and yet you can’t feel anything abnormal in the breast.”

These recommendations are for women at average risk of breast cancer not those who have a family history or the BRCA mutation which puts them at a higher risk of developing breast cancer.

So far, insurance companies are only treating these as recommendations and still following the older guidelines.