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More Breast Cancer Screening Needed in Younger Women

New study suggests expanded screening would reduce mortality rate (September 9)

According to the American College of Radiology (ACR), a new analysis published online Sept. 9 in Cancer confirms the need for greater use of annual mammography in women 40 to 49 years old. It also confirms, the ACR says, that regular mammography screening is still the best way to significantly reduce breast cancer deaths.

The study, which involved 7,301 patients, found that 71% of confirmed breast cancer deaths occurred in the 20% of the study population that did not receive regular mammograms. Most of those who died from breast cancer never had a mammogram prior to diagnosis.

Moreover, 50% of the breast cancer deaths occurred in women under the age of 50, while only 13% were in women aged 70 years or older. For women who died of breast cancer, the median age at diagnosis was 49 years; for those dying of any other cause, the median age at diagnosis was 72 years. This suggests that women under 50 are a primary group in which greater screening compliance would provide the greatest benefit, according to the ACR.

“These findings should quiet those who argue that women age 40 to 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 ACR’s 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.”

Unlike previous studies on the value of mammography that have shown varying benefits, these findings provide more definitive information through a technique called “failure analysis,” which looks backwards from death to discover correlations at diagnosis. Harvard Medical School Professor of Surgery (emeritus) Blake Cady, MD, and his colleagues followed cases of invasive breast cancer diagnosed between 1990 and 1999 at Partners HealthCare hospitals through 2007, analyzing demographics, mammography use, surgical and pathology reports, and recurrence and death dates to discover correlations.

Source: ACR; September 9, 2013.

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