Mammography benefits women in their 40s

Adding carboplatin to chemotherapy is promising for triple-negative breast cancer
Adding carboplatin to chemotherapy is promising for triple-negative breast cancer

Mammography remains beneficial for women in their 40s, according to a new study. It found that breast cancer was diagnosed at earlier stages in women age 40 to 49 years who underwent routine screening mammography, and their tumors were smaller and less likely to require chemotherapy.

In recent years, guidelines have been contradictory regarding the benefit of annual mammograms for women in their 40s. The United States Preventive Services Task Force's guidelines from 2009 recommend against annual screening mammography for women in that age group whereas the American Cancer Society, American College of Radiology, and other professional societies recommend annual screening beginning at age 40 years.

"Our findings clearly underscore the impact of neglecting to screen women with mammography for women in their 40s," said the study's first author, Donna Plecha, MD, director of Breast Imaging at University Hospitals Case Medical Center Seidman Cancer Center and assistant professor at Case Western Reserve School of Medicine in Cleveland, Ohio. "Foregoing mammography for women in this age group leads to diagnoses of later stage breast cancers. We continue to support screening mammography in women between the ages of 40 and 49 years."

In the study titled, "Neglecting to Screen Women Between 40 and 49 Years Old With Mammography: What is the Impact on Treatment Morbidity and Potential Risk Reduction?" the authors compared two groups of women age 40 to 49 years—women undergoing screening mammography and women with a symptom needing diagnostic workup. The study was published in the American Journal of Roentgenology (2014; 202[2]:282-288).

The researchers conducted a retrospective chart review of 230 primary breast cancers and found that patients undergoing screening mammography had significant differences with respect to treatment recommendations, stage at diagnosis, and identification of high-risk lesions than symptomatic women needing diagnostic evaluation. They determined that patients in the screened group were diagnosed at earlier stages with smaller tumors and less likely to require chemotherapy and its associated morbidities. They also found that screening allows detection of high-risk lesions, which may prompt chemoprevention and lower subsequent breast cancer risk.

Breast cancer is a significant health problem and statistics indicate that one in eight women will develop the disease in her lifetime. The stage at which the cancer is discovered influences a woman's chance of survival and annual mammography after the age of 40 enables physicians to identify the smallest abnormalities. In fact, when breast cancer is detected early and confined to the breast, the 5-year survival rate is 97%.

"Annual screening mammograms starting at the age of 40 [years] saves lives," said Plecha. "Breast cancers caught in the initial stages by mammography are more likely to be cured and are less likely to require chemotherapy or as extensive surgery."

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