Risk factors are best determinants of optimal mammography intervals

Recommendations regarding how frequently a woman should undergo mammography screening should be personalized based on a variety of risk factors, according to a team of researchers estimating the cost-effectiveness of mammography based on several risk factors.

Experts—and guidelines—disagree on the optimal screening intervals for mammography, noted a team of investigators in a study published in Annals of Internal Medicine (2011;155[1]:10-20). Using data from the Surveillance, Epidemiology, and End Results (SEER) program, Breast Cancer Surveillance Consortium, and the medical literature, the investigators sought to ascertain costs per quality-adjusted life-year (QALY) gained and number of women screened over 10 years to prevent one death from breast cancer. They determined the following:

  • Annual mammography was not cost-effective for any group of women, regardless of age or breast density.
  • Mammography performed every 2 years was cost-effective for women aged 40 to 49 years with relatively high breast density or additional risk factors for the disease.
  • Mammography performed every 3 to 4 years was cost-effective for women aged 50 to 79 years with low breast density and no other risk factors.

These findings led the researchers to conclude that mammography screening intervals should be personalized based on the woman's age, breast density, history of breast biopsy, family history of breast cancer, and beliefs about the potential benefits and harms of such testing.

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