What's the best schedule for mammograms to screen for breast cancer?

What’s the best schedule for mammograms to screen for breast cancer? Truth is, no one really knows. In the US common wisdom is to test every year, starting at 40 or so, and continuing until your life expectancy is low enough that you wouldn’t do anything with the results.

In the EU, the recommendation is every 2-3 years

European breast cancer guidelines recommend screening every 2 to 3 years (healio.com)

The panel found that women aged 45 to 49 years should receive screening every 2 to 3 years , women aged 50 to 69 years should be screened every 2 years, and women aged 70 to 74 years should be screened every 3 years.

I think the UK recommends every three years.

But there isn’t a lot of good prospective research on the matter. And a lot of doctors think that we do too many mammograms, and find a lot of cancers that would never have grown, leading to a lot of worry and unneeded surgery and other treatments.

Anyway, someone has organized a large prospective study. It randomizes women into two groups, one of which will get annual screenings, and the other will get genetic screening and some other schedule of mammograms based on the results of that information.

I just joined. They put me in the “individualized” arm, and I just spit in a test tube and put my sample in the mail. (You can choose one arm, but the more people are actually randomly assigned, the better the results, so I let them randomize me.)

If you identify as a woman, are age 40-74, live in the US, and have never had breast cancer, you are eligible to join, too. They are looking for 100K woman, and have something like 50K, so there’s plenty of room to join.


One data point:
At age 35, I had never had a mammogram. I felt a lump so went in. I had stage 1 BC.

Genetic testing showed BRCA negative. So I did lumpectomy plus chemo, radiation and chemically induced menopause for 5 years.

13 years later at 48, I had a clear mammogram in January. By October, I felt a lump. I was stage 2. Further genetic testing found I am CHK2+ which made me more prone to BC.

Ultimately, mammograms did me no good. But being it’s an easy tool for early screening, idk why anyone would argue for fewer of them. :woman_shrugging:

Both of my daughters were tested for the gene I have. Both are negative. So fuck you cancer, this shit dies with me. :+1:


Yeah I’d rather be safe than sorry.

My mom’s been forcing everyone in our family to do colonoscopies after my grandfather (her dad) and my aunt (her older sister) died of colon cancer.

My dad, brother, and her all had polyps found and removed, some more ominous than others. My brother in particular had polyps found in consecutive years, and the biopsies revealed that the cells were the kind that were prone to become malignant. This was all paid out of pocket in Asia. They’re kind of luxury complete physicals that you can do, and they give fancy robes and meals and stuff.

My doctor here says that’s not really a thing in the US, because you can find too many things wrong when you test like a hundred things, some are just within the expectation of statistical significance, and you’re always going to find something wrong when you’re testing like a hundred things.

But colonoscopy is something I think should become more common before the age of 35 if you have family history (my brother was in his early 30s when he had the back to back polyps removed).

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I’m not convinced.
I’ll need to check it myself.

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I argue for fewer mammos because of false positives. Honestly it feels like a racket. How much money do we spend in this country investigating false positives from mammograms and or treating “stage 0” cancers that were never gonna grow?

Obviously people with higher risk ought to be able to get a mammogram every year. But I should not be pressured to get one every year if I’m comfortable with every 3 years. (I got a 3D mammo this year, it was fine, I’m good for a while).

I know we’ve been asked to keep the language clean, but…

FUCK CANCER!!! :face_with_symbols_over_mouth: :face_with_symbols_over_mouth: :face_with_symbols_over_mouth: :face_with_symbols_over_mouth:


The information you get from a colonoscopy, and the “next steps” are very different as compared to a mammogram.

Typically, if a colonoscopy finds something, it’s either a precancerous polyp or a dangerous cancer. If they find a polyp, they can snip it off as they do the colonoscopy, and the only further treatment is to recommend more frequent colonoscopies. The snip is painless and quite safe. No one dies years later as a result of a polyp being snipped off. And you don’t really have to worry, because by the time the procedure that found the polyp is complete it’s been taken care of.

With a mammogram, finding something means you need to go back for more stuff. And worry until that happens. And the more stuff is painful and invasive. And if they decide you have an early stage cancer, you might get a lot of treatment that is, itself, to dangerous. But in many cases, no one knows if it’s really a dangerous cancer or one of those quiet little tumors that people routinely die with, not of. (Like many prostate tumors.) I mean, sometimes it’s obviously dangerous, but those ones can often be felt, like Serena’s.

People with family histories of colon cancer can start getting insurance to pay for a colonoscopy fairly young in the US, although I’m not certain how young.

And despite the value of colonoscopies, the only people who get them annually are people with known extremely high risk.

Which reminds me, it’s time for a colonoscopy… Sigh.

yeah this is what I don’t like about the US system. It’s more about dealing with things once stuff is found, and not so much preventative. Cancer especially, once people suspect that they have it and go in for a check up, it’s usually too late.

I think the recommended age for a colonoscopy is way too late in the US

The USPSTF currently recommends that people at average risk starting screening at age 45.

Like what…

I think my doctor said even my grandpa and aunt are too distant in terms of family history, it needs to be like my parents before insurance would start covering for early age screenings.

Huh. I have a couple of friends who i thought started getting screened at 40, but maybe they had parents with issues? They both had polyps removed from that first screening, whatever the age was.

I’m sure you can find someone who’ll do it for cash, especially if you have a family history. The prep is a nuisance, but it’s worth it to avoid colon cancer.

Yeah, I usually do it in Asia for that reason, because it’s a fraction of the cost, with luxury amenities.
I don’t even really wanna know what it’ll cost to do it in the US without insurance.

IANAD but some countries are hesitant to perform a colonoscopy unless there is family history or something like Cologuard comes up with blood in the stool. This is because colonoscopy is an invasive procedure and has the risk of colonic perforation and other complications, which can have serious implications. I can’t find what the incidence of this is in procedures performed currently but a Yale study in 2010 found -

“1.6% of 325,000 otherwise low-risk healthy patients who had a colonoscopy in the year 2010 experienced a complication serious enough to send them to a hospital or emergency department within 7 days.”

If the probability of severe complications (including death) from a colonoscopy is higher (for patients with no family history and negative Cologuard tests) than the probability of a severe outcome from colon cancer, then it doesn’t make sense to get one.

I did sign up for the Wisdom study.


Me too.


For colon business, I did the “poop in a cup” method. My insurance covered it.

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What are “luxury amenities”? A shorter time spent in a nicer waiting room?

Basically they try to make the experience enjoyable. Chef made light weight healthy meals after your colonoscopy, nice sitting areas, nice changing rooms, etc.

It’s a private physical exam practice, but expensive by Asia standards. Less wait time as well, and more organized. And you get through everything pretty fast, endoscopy, colonoscopy, bloodwork, ultrasound, etc.

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Hmmmm, sounds good to me. Maybe I should try this.

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I’m 46 and reading this thread I was starting to feel guilty that I hadn’t had a colonoscopy yet until I read this. The only cancer in my biological family is my maternal grandmother who smoked and died of lung cancer. Since I don’t smoke I’m hoping that I can avoid that. I should be pretty low risk for basically every kind of cancer. Maybe I’ll wait a bit longer.

Sadly, lots of in-laws have had various forms of cancer, but no non-smoking blood relatives.

Yeah, it only costs a thousand dollars more to save three hundred.

I highly recommend poop-into-a-cup.

It’s officially called Cologuard, but I like my description more.