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When is a good time to get a mammogram? When you are 40? Or is it 50? And what if you have a family history?

“It seems like when you just get it figured out how often you need to return for a mammogram or a pap smear, they go ahead and change the rules,” said Heidi Grondahl, WHNP, a member of the Family Medicine team at Trinity Community Clinic – Western Dakota, in Williston. “Nowhere is this more prevalent than in screening guidelines; and there are many – one for each body part, it seems.”

The decision on when to get a mammogram should be made following a discussion between the patient and their healthcare provider, she said, adding that the need for a mammogram is somewhat individualized. “While  we have guidelines, there are personal factors that we  must consider as well in deciding when to start, finish, and how often we are doing screening.”

At the same time, she understands the concern about  getting a mammogram too early because “you can  over-intervene, and that can be harmful.” Mammograms may be harder to read if you are pre-menopausal, as breast tissue tends to be far denser, “and the tests aren’t as accurate,” she added.

The American College of Physicians (ACP) issued new breast cancer screening guidelines a couple of  years ago for average-risk women under the age of  50 with no symptoms of breast cancer. The  recommendations state that at the age of 40,  women should speak with their primary healthcare  provider about the benefits, harms, and personal preferences of screenings. Mammogram screenings  should otherwise start at the age of 50 and annually  up to the age of 74.

The ACP noted that women at a higher risk of  breast cancer or anyone with prior abnormal screening results should get screened before the  age of 50.

However, the American College of Radiology (ACR) and Society of Breast Imaging (SBI) disagree, saying  that these recommendations “may result in up to 10,000 additional, and unnecessary, breast cancer  deaths in the United States each year.” The recommendations could also likely result in  “thousands more women enduring extensive  surgery, mastectomies, and chemotherapy for advanced cancers.”

According to the Centers for Disease Control and  Prevention (CDC), screenings carry the risk of false  positive tests, which can lead to more tests, thus  more of an expense, not to mention the invasiveness, time, and/or anxiety. With the balance  of the harm versus the help of frequent  mammograms, the topic “becomes more an of  emotional argument,” Grondahl said.

However, certain risk factors – having a significant family history of certain cancers (breast and  ovarian) – would understandably lead to a person  getting screened earlier. Overall, Grondahl  suggested seeing your provider for a yearly health  maintenance exam. “This is the best time to talk  about the screenings you are due for and it is one exam that most insurances pay in full, without  additional cost to you.”

To schedule a mammogram, please call Trinity  Health’s Breast Imaging Center scheduling line at  701-857-2640; for mammogram services at Trinity Community Clinic – Western Dakota, in Williston,  call 701-774-0810. Referrals are not needed for mammograms.