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B.C. agency urges women at high risk of breast cancer to screen annually, others every two years

A mammogram.

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A new breast cancer screening policy for British Columbia urges women aged 40 to 74 to have annual mammograms if their mothers, sisters or daughters have been diagnosed with breast cancer.

The B.C. Cancer Agency released new guidelines Tuesday, describing the recommendation as a step toward personalized cancer screening.

Dr. Christine Wilson says research has shown that women who have a so-called first order relative with breast cancer have two times the risk of developing the disease than women who do not.

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Wilson says the B.C. Cancer Agency will send women in this high-risk group recall messages.

The revised guidelines recommend screening every two years for other women between the ages of 50 and 74, the age group in which more than 80 per cent of breast cancers are detected.

The B.C. Cancer Agency is also allowing women aged 40-49 to be screened every two years without a doctor's referral, though it urges women in this age group to discuss the pros and cons of screening with a health-care provider.

The same is true for women aged 75 and older.

Screening in the 40-to-49 age group is contentious, with studies suggesting there is less benefit for women under age 50 and a higher risk of false positive tests that must be followed up.

Previously, the agency permitted women aged 40 to 49 be screened every year.

The Canadian Task Force for Preventive Health Care recommends against routine breast cancer screening in women aged 40 to 49. And Cancer Care Ontario says women in this age group who want to undergo screening mammography should talk with their doctors first.

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Wilson says the B.C. Cancer Agency has decided to "take the more permissive stance."

"The idea is that we want woman to have that discussion with their family doctors or nurse practitioners about really, is screening right for them or not? And if they choose it, then it is," says Wilson, a radiologist and the medical director of the B.C. Cancer Agency's screening mammography program.

"The evidence shows there is still a benefit in terms of mortality reduction for the screened group."

Women under 40 would need a doctor's referral to undergo screening mammography.

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