Mammography screening performed annually is the best option for women age 40 to 49, according to a review published online May 15 in the Journal of Breast Imaging. Annual screening is recommended for three main reasons, not least of which is a reduction in breast cancer mortality between 29% and 49%.
Benefits will continue to improve
While the article is highly clinical in nature, the author of the review, Dr. Stephen Feig of the University of California-Irvine claimed that advanced in mammography and its techniques, along with breast ultrasound, may result in even better results in the future.
Good — no GREAT — news for early detection and beating the disease.
According the author, a woman’s likelihood of developing breast cancer over the next decade increases as she ages. Women at age 40 have a 1.44% chance of developing cancer in the next 10 years. Their individual risk is 1 in 69. For women at age 50, the likelihood is 2.39%, with an individual risk of 1 in 42.
The viewpoint is that the data supports the recommendation to beginning screening for breast cancer at age 40 rather than wait until 50.
The three points
In an online article summary published by the radiology business website, Aunt Minnie, Feig makes three main points:
- Randomized controlled trials and population-based screening studies underestimate mammography’s benefits. “There have been many common limitations in the conduct of virtually all randomized trials and service screening studies that have resulted in underestimates of benefit from screening,” he wrote. “These include excessively long intervals between screenings, recall rates that were too low, and biopsy thresholds that were too high. Many studies do not continue screening over a sufficient number of years. Additionally, there have been many successive technical transitions in mammography since these studies were conducted.”
- Advances in treatment don’t reduce the importance of screening younger women. “There has been a 40% decrease in breast cancer deaths among women of all ages in the U.S. from 1989 to 2016,” Feig wrote. “Several mathematical models suggest that earlier detection through screening and advances in chemotherapy, hormonal therapy, radiation therapy, and surgery have all contributed toward reduction in breast cancer mortality. However, modeling provides inaccurate estimates for the relative contributions of screening versus treatment.”
- No randomized trial has been designed to compare the relative benefit for different screening intervals for women in their 40s. “Much of the evidence for selection of the best screening frequency for those women is indirect and based on computational models,” he wrote. “[But] using data from the National Cancer Institute (NCI) Breast Cancer Surveillance Consortium … [researchers] found that women ages 40 to 49 years that chose to attend annual mammography were significantly less likely to have node-positive disease than those who attended screenings every other year.”
The bottom line? Screening should start at age 40 and continue annually, Feig concluded.
While the talk of trials, studies and models may make a lay person’s head spin, the above bottom line for many becomes clear. Early detection at an earlier age saves lives. And mammography is the best option.
Diagnostic Imaging Services performs screening and diagnostic mammograms in Metairie, Marrero, Slidell and Covington. Call 504-883-5999 or 985-641-2390 for a breast cancer screening mammogram. Or, click here to send us an email requesting assistance.