The Tests Women Really Need [part1]

The path to early detection of cancer used to be clear: You have your annual Pap first time after starting to have sex, and its inaugural annual mammogram at age 40 - also doing a breast self-exams. But recently, the American College of Obstetricians and Gynecologists (ACOG) and the U.S. Preventive Services Task Force (USPSTF) issued new recommendations of the evidence, not to postpone the initial trials and waiting longer between screenings, which unleashed a firestorm of controversy.

Why the sudden change? Both groups changed their positions after studying the evidence that less frequent testing may be as effective in the diagnosis of cancer, and that would cost less and deny unnecessary follow-ups. Most physicians, however, according to a one-size-fits-all exam schedule and the stress is critical for women to always have frank discussions with their gynecologists. (This adventure that we had last year in Las Vegas? His "social smoking" habit? Stroke.) Your MD will help you design a customized calendar, but you should start with the following tips.

Mammograms
The American Cancer Society has long held that women should have their first annual mammogram at age 40, but the USPSTF now says most don't need them until they turn 50

The reasoning? Younger, denser breasts are more likely to produce benign cysts, and aggressive testing on innocent lumps is expensive and unnecessary. But some doctors are sticking with earlier screenings until studies prove that fewer exams won't equal higher fatalities, says Carolyn Runowicz, M.D., director of the Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut. "Everyone agrees that mammography reduces mortality in women over 40," she explains. Still, she adds, "It's key to understand that mammograms are effective, but they're not perfect." They can miss cancers or "overread" some benign changes.

The bottom line: Get tested annually starting at age 40, or earlier if you have a family history of breast cancer. Start screenings 10 years earlier than the age of your relative at the time of her diagnosis (so if your mom was diagnosed at age 42, for example, you should have your first mammogram at 32).