Article from: The Advisory Board Company © 2010 . All rights reserved. Article URL
06 May 2010
Mammograms detect few breast cancers in women younger than age 40 and often lead to more tests and unwarranted anxiety because of false positives, according to a study published Monday in the Journal of the National Cancer Institute, Reuters reports.
For the study, radiologist Bonnie Yankaskas of the University of North Carolina-Chapel Hill and colleagues analyzed the medical records of 117,000 women ages 18 through 39 who received their first mammogram in 1995. After one year, no tumors were identified in women younger than age 25. In addition, 12.7 per 1,000 women ages 35 to 39 required additional tests after their mammograms detected a lesion, though very few had cancer, Reuters reports.
“In a theoretical population of 10,000 women aged 35 to 39 years, 1,266 women who are screened will receive further workup, with 16 cancers detected and 1,250 women receiving a false-positive result,” the study found. The study added that before a woman receives a mammogram, “[h]arms need to be considered, including radiation exposure because such exposure is more harmful in young women, the anxiety associated with false-positive findings on the initial examination, and costs associated with additional imaging.”
In an accompanying editorial, Ned Calonge of the Colorado Department of Public Health and Environment suggested that women younger than age 40 do not receive mammograms unless they detect a lump in their breast (Fox, Reuters, 5/3).
The age at which women should begin routine breast cancer screenings is a subject of debate among experts, the AP/Miami Herald reports (AP/Miami Herald, 5/3). In November 2009, the U.S. Preventive Services Task Force issued guidelines suggesting that most women should begin routine mammograms to screen for breast cancer at age 50, not age 40 as previously recommended. In setting the new guidelines, the experts weighed the benefits of early screening against the risks, including the chance that a mammogram could result in a false positive, prompting unnecessary treatments and stress (Women’s Health Policy Report, 11/17/2009).
In January, the American College of Radiology and the Society of Breast Imaging issued guidelines recommending that women with an average risk of breast cancer begin regular mammograms at age 40 and that women with an elevated risk begin screenings at age 30 (Women’s Health Policy Report, 1/5).
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