New national advice on when to get mammograms is landing with a thud in Chicago exam rooms.
The American College of Physicians (ACP) has rolled out new guidance saying most average-risk women should get screening mammograms every two years starting at age 50. Breast specialists here are not thrilled. Dr. Sonya Bhole, a breast radiologist and associate professor at Northwestern Medicine, told CBS Chicago she was “disappointed” and warned that stretching the time between exams could leave younger people - especially those with dense breasts or a family history - more vulnerable. The clash highlights how major medical groups still do not agree on how to balance early cancer detection with the risk of overdiagnosis and extra procedures.
What the ACP Recommends
According to the American College of Physicians, the new guidance, published in the Annals of Internal Medicine and presented at the ACP Internal Medicine Meeting, advises that asymptomatic, average-risk females ages 50 through 74 receive screening mammograms every other year instead of annually. For people in their 40s, the ACP calls for shared decision-making, meaning patients and clinicians should weigh the pros and cons together before starting routine screening.
The ACP statement says that switching from yearly to biennial screening cuts down on false positives, short-interval call-backs and biopsies that ultimately turn out to be unnecessary. It also recommends that clinicians talk with patients 75 and older, or those with limited life expectancy, about stopping routine screening altogether.
How Other Groups Differ
Not everyone is on board with that slower pace.
The American Cancer Society recommends annual mammograms for most people ages 45 to 54. It also says individuals 40 to 44 should have the option to begin screening if they want to. After 55, the ACS advises that patients may move to every-other-year screening or stick with yearly exams, depending on preference and clinical judgment.
Major imaging organizations take an even more aggressive stance. The American College of Radiology and the Society of Breast Imaging blasted the ACP recommendations as “out of step” with cancer experts and warned that delaying or cutting back on screening could lead to more advanced cancers and preventable deaths. They continue to push for annual screening starting at age 40, along with early risk assessment and tailored strategies for people at higher risk.
Local Reaction
That national fight is playing out locally in exam rooms and imaging centers.
“Waiting two years allows that cancer to grow,” Dr. Sonya Bhole told reporter Audrina Sinclair in an interview with CBS Chicago. She said women ages 40 to 49, people with dense breast tissue and those with a family history of breast cancer may be hit hardest if screening is delayed and should have their risk assessed earlier.
Local physicians are urging patients not to skip recommended clinical follow-ups or brush off new symptoms while national societies debate the fine print. The message from Chicago doctors is essentially: do not let a guideline update be the reason you ignore a lump.
Evidence and Rationale
Per Medical News Today, ACP authors say their recommendation is based on systematic reviews and decision models that found only modest additional mortality benefit from annual screening, compared with much higher rates of false positives and biopsies. In other words, you may catch a few more cancers a little earlier with yearly mammograms, but you also send a lot more people through stressful extra testing.
The guidance notes that the panel’s conclusions depended heavily on the certainty of the evidence, assumptions that people stick with screening over time, and how they weighed harms versus benefits. That basic tradeoff - more cancers caught early versus more tests and procedures - sits at the heart of why different medical societies land in different places.
What Patients Should Know
For patients, doctors say the marching orders are straightforward: know your risk, know your body and talk to your clinician.
That means asking about family history, breast density and any other factors that might push your risk higher or lower, then making a screening plan together. The American Cancer Society stresses that screening is still one of the most powerful tools for catching breast cancer early and recommends that people discuss both timing and frequency with their healthcare provider.
And one point everyone agrees on: if you notice a new lump, nipple change or any other concerning symptom, get it checked out promptly, no matter when your last mammogram was.
