Women between the ages of 40 and 49 need annual mammograms, according to a new study. Study authors also suggest that regular mammography screening is the best way to significantly reduce breast cancer deaths.
The research, published in Cancer, involved 7,301 patients, and showed 71 percent of confirmed breast cancer deaths occurring in the 20 percent who did not receive regular mammograms. The majority of study participants who died from breast cancer had never had a screening mammogram prior to diagnosis. Fifty percent of the deaths were in women under age 50, and the median age at diagnosis was 49.
Younger Women Need Mammograms
“These findings should quiet those who argue that women age 40-49 do not need regular mammography screening. In fact, these women need annual screening — as do all women 40 and older. This is the message physicians should be promoting,”¯ said Barbara S. Monsees, MD, FACR, chair of the American College of Radiology Breast Imaging Commission. “Breast cancer treatment has come a long way, but, as this study demonstrates, these advances have not negated the value of, or the need for early detection. This is especially true for younger women, who tend to have faster growing tumors.”¯
Here We Go Again
In 2009, the U.S. Preventive Services Task Force (USPTF) stirred up a controversy when it changed its guidelines regarding mammography screening, citing psychological harms due to unnecessary testing, false-positives, and over diagnosis. Radiation exposure was cited as a minor concern. The new guidelines recommend no mammography screening in low risk women under age 50 or over age 75. For women in the 50-74 year-old age group, it recommends mammograms every other year rather than every year. Perhaps the bigger controversy is their recommendation against teaching breast self-examination.
Breast Health Is In Your Hands
Nonprofit Beyond Boobs! supports young women diagnosed with breast cancer and promotes breast health education for all. The organization continues to encourage breast self-examination as a noninvasive and free early detection tool. As a breast cancer survivor who found her own lump, I’m inclined to agree.
I’m having a tougher time with the mammogram issue, so I asked Beyond Boobs! Co-founder and Executive Director Mary Beth Gibson to weigh in. “Until we find a way to determine which breast cancer cells will become life threatening and which breast cancer cells do not necessitate intervention, mammography remains the best tool we have for finding breast cancer at its earliest stages.
“The majority of women of Beyond Boobs! who were diagnosed with breast cancer in their 40s found their cancers with mammography. I can say with total confidence that none of them would have wanted to wait until 50 for their first mammogram.
“We are not a statistic — we are women whose lives may have been saved by beginning mammography in our 40s,” says Ms. Gibson. “Many of these women were also able to choose less invasive surgery and treatment as a result of finding their breast cancers earlier than if they had waited.”
I also reached out to surgical oncologist Diane M. Radford of Mercy Clinic St. Louis Cancer & Breast Institute. “This study provides additional information that mammography screening in younger women is of value,” says Dr. Radford. “In my own breast surgery practice, 25 percent of patients with breast cancer are younger than 50 years old. Although the USPTF recommends mammography starting age 50, the American Cancer Society, the American Society of Breast Surgeons, the American College of Radiology, American Society of Breast Imaging, and the American Congress of Obstetricians and Gynecologists all recommend mammography starting age 40.”
To Mammogram or Not to Mammogram
“The ‘when to mammogram’ question is complex, and the study didn’t alter the dialogue,” says Gibson. “Informed women must evaluate the pros and cons and discuss it with medical professionals who truly understand the issues.”
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