| Former Guidlines 1997 | Updated guidelines and information (May 2003) | Explanation |
| Mammography | Annually starting at age 40 | No change from 1997 recommendation. There is a tremendous amount of additional, credible evidence of the benefit of mammography since 1997, especially regarding women in their 40s. | Women can feel confident about the benefits associated with regular screening mammography. However, mammography also has limitations: it will miss some cancers, and it sometimes leads to follow up of findings that are not cancer, including biopsies. |
| CBE | Every three years for women 20-39; annually for women 40 and older | CBE should be part of a woman’s periodic health examination, about every three years for women in their 20s and 30s and annually for women 40 and older. | CBE is a complement to regular mammography screening and an opportunity for women and their health care providers to discuss changes in their breasts, risk factors, and early detection testing. |
| BSE | Monthly starting at age 20 | Women should report any breast change promptly to their healthcare provider.Beginning in their 20s, women should be told about the benefits and limitations of BSE. It is acceptable for women to choose not to do BSE or to do it occasionally. | Research has shown that BSE plays a small role in detecting breast cancer compared with self awareness. However, doing BSE is one way for women to know how their breasts normally feel and to notice any changes. |
| Older women and women with serious health problems | Additional research is needed. | Mammograms should be continued regardless of a woman's age, as long as she does not have serious, chronic health problems such as congestive heart failure, end-stage renal disease, chronic obstructive pulmonary disease, and moderate to severe dementia. | There is a need to balance the potential benefits of ongoing screening mammography in women with limited longevity against the limitations. |
