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Review Question - QID 105647

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QID 105647 (Type "105647" in App Search)
A 50-year-old woman with a history of hypertension presents to her primary care physician for a routine visit. She has no personal history nor family history of breast cancer. When should this patient receive a screening mammogram?

When she turns 55-years-old, and every 1 year thereafter

7%

4/54

This year, and every 1 to 2 year thereafter until the age of 75

35%

19/54

This year, and every 1 to 2 years thereafter until the age of 85

31%

17/54

This year, and every 5 years thereafter

19%

10/54

Screening mammograms are no longer recommended in patients without a family history of breast cancer

6%

3/54

Select Answer to see Preferred Response

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Screening mammograms are recommended every 1-2 years in women age 50-75.

According to the most recent United States Preventative Services Taskforce (USPSTF) guidelines issued in 2009, screening mammography should be conducted every 2 years in women between the ages of 50 and 74. Routine mammograms are not recommended for women age 75 and above. The USPSTF recommends against breast self-examination, and teaching breast self-exam technique is no longer a priority for the physician. In general, starting at age 50 and repeating the exam every 1 to 2 years is appropriate.

Klein reviews the diagnostic modalities used in the evaluation of breast cancer, "Mammography screens for occult malignancy in the same and contralateral breast and can detect malignant lesions in older women; it is less sensitive in women younger than 40 years. Ultrasonography can detect cystic masses, which are common, and may be used to guide biopsy techniques."

USPSTF guidelines published in the Annals of Internal Medicine in 2009 state, "The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms." This recommendation remains a point of great controversy in the physician community.

Illustration A shows a normal mammogram. Note the consistent appearance of the tissue throughout the breast. Illustration B shows 4 mammograms, all of which are normal. The amount of adipose tissue present in the breast varies with each woman, giving the 4 breasts different appearances. A denser breast, such as the one on the right, makes it more difficult to detect cancer on a mammogram.

Incorrect Answers:
Answer 1,3,4: The patient should receive a screening mammogram this year and every 1-2 years thereafter until the age of 75.
Answer 5: Lack of family history does not affect screening mammography recommendations for patients between 50 and 74 years of age.

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