Mammograms and women’s lives are unfortunately up for debate again with the recent release of the American Cancer Society’s (ACS) breast cancer screening guidelines that raise the screening age from 40 to 45.  These guidelines are causing further confusion among women, as we now have conflicting guidance from at least four major medical organizations. So, what are women to do when the "leading authorities" don't agree on what's best? With the experts in limbo, it is clear that we cannot continue with the status quo. It’s time for a “time out” so we can determine what is best for women and ensure if she wants and needs a mammogram, her insurance will continue to cover it.

Let me back up.  As a Stage 2, triple negative breast cancer survivor and the head of a national advocacy organization dedicated to educating and empowering young breast cancer survivors, I know the importance of annual mammograms.  After all, if I did not have access to testing, I would not have benefited from early detection. Even though I told that I was too young to have breast cancer at 31, I kept pushing for screening. When the cancer was found, it was fortunately still early enough to be treated, and here I am today, ten years later, cancer free.


Early detection has saved thousands of lives like mine, which is why raising the screening age is so troubling. Yet, while the recent ACS guidelines stoked breast screening confusion, they did not start the fire. Earlier this year, the United States Preventive Services Task Force (USPSTF) released even more worrisome recommendations. If finalized as proposed, the guidelines could limit access to mammograms because insurance companies would no longer be required to cover mammograms without cost sharing for women in this age group. This would impact 22 million women, including 2.8 million African American women who have the highest rate of mortality from breast cancer and also are 45 percent less likely to have health insurance than white women.

The decision to screen should not be determined by who can afford it. For many women in America, having to pay for a mammogram would be a deterrent to getting this critical exam. Women would continue to delay their mammogram or not go at all, meaning cancers would go undetected or caught at a later stage when mortality rates are higher and more invasive treatments are needed.  For every woman, particularly the younger women Tigerlily Foundation serves, this could mean the difference between life and death.   

You may be wondering why mammograms are under such scrutiny. A common thread amongst critics is that while mammograms save lives, the harms outweigh the benefits. One such “harm” is the false positive, which claims that women would feel afraid, anxious and inconvenienced. However, most women I know are not fragile flowers, but fearless warriors. They would prefer short-term anxiety to a missed cancer with a grim prognosis that could have been detected earlier. In my case, I would choose additional tests, anxiety, worry or pain any day over having to tell my daughter I was dying because I waited too long.

Another common argument is that over-diagnosis of breast cancer is a reason not to screen, pointing to women undergoing unnecessary treatment for a cancer diagnosis that may end up being benign. However, information is not the enemy. Until science can tell us for certain which cancers are life threatening and which are harmless, we need to screen regularly.   

If the USPSTF’s proposed changes are implemented, millions of women are at risk for losing access to mammograms. That’s why I call on Congress to pass the Protect Access to Lifesaving Screenings (PALS) Act (H.R. 3339 and S. 1926). This bipartisan legislation would place a two-year moratorium on implementing the USPSTF breast cancer screening recommendations. It’s the time out we need to stop the confusion and figure out what is best for women while ensuring ongoing access to mammograms.  At a time like this, shared decision-making - between advocates, policy-makers, healthcare providers, insurance companies and all stakeholders, is more important than ever. 

At the end of the day, every woman should be empowered to make her own decisions with her doctor based on personal history, family history and what feels right for her; not based on  financial status, misguided claims about anxiety, misinformation or age barriers.  Let’s give all women a fighting chance against breast cancer by making sure barriers to access are never the reason that we lose a life to breast cancer. 

Karmo is president and founder of the Tigerlily Foundation.