Routine mammograms, self-exams and MRIs not needed for most women under 50

Clinical breast exams are no longer routinely recommended for women at average risk of breast cancer, according to new Canadian guidelines.

That’s the main change in Monday’s updated guidelines from the Canadian Task Force on Preventive Health Care.

An analysis also found routine mammography, self-examinations and MRIs had no significant benefit for women aged 40 to 49.

The task force also warned there was potential for harm from over-diagnosis and unnecessary biopsy, particularly for younger women.

“We’re trying to reframe this set of guidelines away from a prescriptive approach, which makes a one-size-fits-all recommendation for women based on their age, and change it into a discussion between a woman and her doctor about the potential risks, about the potential benefits, and allow each woman to make a decision that’s right for her,” said Dr. Marcello Tonelli, the chair of the task force and a professor at the University of Alberta’s Department of Medicine, in Edmonton.

The guidelines cover women up to age 74 who are at average risk, meaning they have:

  • No previous breast cancer.
  • No history of breast cancer in a first-degree relative such as a mother or sister.
  • No known mutations in the BRCA1 or BRCA2 genes.
  • No previous exposure to radiation of the chest wall.

The new guidelines also recommended a change in how often screening mammograms should be offered for women 50 to 74 — from every two years to every two to three years.


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