Mammogram screening: what speaks for – and against

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Written By Kampretz Bianca

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Should I participate or not? Millions of women in Germany ask themselves this question every two years when the invitation for mammography screening arrives in their mailbox. The 50 to 69 age group has been entitled to chest X-rays for almost 20 years. From July 1, 2024, the age limit will be raised to 75 years. This means that the test is now available to around 14.5 million women.

The purpose of mammography: detect breast cancer early and reduce the long-term mortality rate. We provide an overview of who is eligible, when, and what is known about the benefits and risks. There are also tips on how to know if your gynecologist is giving you good advice about screening.

People aged 70 to 75 must register initially

Women aged 70 to 75 are now eligible for mammography screenings. The backdrop to the expansion is the updated recommendations of the European Commissionto strengthen early cancer detection. However, women themselves have to act; for now, they will not receive an invitation suggesting an appointment at a screening unit close to their home. According to Federal Joint Committee Extensive preparations and adjustments to the current offering are required. A mail-in appointment offer will likely only be available from 2026.

Tip: Temporarily, people aged 70 to 75 may have a Mammography consultation at the regionally responsible central office to agree. The last mammogram must have been at least 22 months ago at the time of requesting the appointment.

Taking part in a cancer screening test is voluntary and the decision is very personal. Weigh the advantages and disadvantages individually. Can anyone be helpful Decision support to be.

The proven advantage for the elderly is very small

The downside: As you age, the likelihood of dying from a disease other than breast cancer increases. And few studies examine the benefits of breast cancer screening in women aged 70 and over. The results are in line with IQWiG (Institute for Quality and Efficiency in Healthcare) are not as clear and meaningful as for younger people and are not sufficient to quantify the benefit for women aged 70 and over (see Benefits and risks of early detection of breast cancer).

IQWiG therefore transferred existing data from older studies for younger women to older women and performed model calculations. In its final report, it classified the benefits of mammographic screening for older women as greater than the associated harms. However, it emphasizes: The proven advantage for the individual woman is only very small and individual consideration remains essential.

Tip: Get advice from your gynecologist about the benefits and risks. Our Testing the quality of advice (Downloadable PDF). However, 2014 revealed clear shortcomings. Find out how you can recognize good advice in our Tips.

The breast cancer death rate is falling

Although breast cancer remains the most common type of cancer in women, it is not the most dangerous. The risk of dying from breast cancer has been reduced by more than half in the last 50 years. This is proven by current data from the USA, which the specialized magazine Jama Published. The numbers here go in the same direction. Experts say that the reasons for the positive development are, on the one hand, constantly improving therapies and, on the other hand, the introduction and expansion of early detection.

Early detection of breast cancer under discussion

Mammogram screening has been controversially discussed in science and the media for years. Critics say: Many women don’t know that participation in screening is individual can be beneficial, but can also be harmful.

Important to know: Mammograms do not protect against breast cancer. It cannot prevent the development of breast cancer, it can only detect it at an early stage. This is not a preventative test, but rather an early detection test.

Expansion also available for those aged 45

Younger women, ages 45 to 49, may also be included in mammographic screening in the future. This is what the EU Commission, IQWiG and I recommend Federal Office for Radiological Protection (BfS). The risk of radiation is relatively low and studies on its benefits are good. According to the Federal Joint Committee (G-BA), consultations on reducing the age limit are already underway. He decides on the benefits of legal health insurance companies. A decision is expected in 2024. Formally, this also requires an amendment to the Breast Cancer Early Detection Ordinance.

3D mammography is also under discussion

Before lowering the age limit, the Federal Office for Radiological Protection must assess whether 3D mammography (tomosynthesis) can be approved for the early detection of breast cancer in certain cases. A spokesperson for the Federal Ministry responsible for the Environment and Consumer Protection said this when asked by test.de. With this development of mammography, mammary gland tissue can be better evaluated due to the three-dimensional layered representation, since breast tissue structures can be seen without overlapping. Above all, they could Women with dense breast tissue to benefit.

Mammography is also possible much earlier

Outside of screening, all women with suspected breast cancer – regardless of age – are entitled to a mammogram. For early detection of breast cancer, women aged 30 and over can have annual breast exams. For example, if gynecologists feel a lump or see abnormalities during an ultrasound exam, they may refer affected women to a radiologist for a mammogram.

Tip: If you notice any changes in your breasts, contact your doctor directly. These can be palpable lumps, dents, hardening of the breast, but also visible deformations, changes in the skin, nipple retractions or bleeding from the nipple.

What helps prevent cancer and detect it early

Protect yourself against skin cancer. The number of deaths from skin cancer is increasing. Treatments for skin cancer have increased in Germany over the past 20 years. In the long term, UVA and UVB rays can cause skin cancer. Our tests show which sunscreens offer reliable protection Sunscreen for adults It is Sunscreen for children.

Early detection options. Skin cancer screening exams performed by a dermatologist are free for adults every two years. We find out if apps can distinguish skin cancer from harmless age spots Testing Skin Screening Apps examined.

Helps with diagnosis. If you have been diagnosed with a precursor to white skin cancer, medication may help Actinic keratosis help with the application. Our guide is available to family members of cancer patients Cancer diagnosis Guidance and lots of tips to support and deal with mental stress.

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