Why Mammography Should Begin at 40

Breast cancer detected by mammography at younger ages saves lives

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(RxWiki News) When a woman should begin receiving breast cancer screening mammography has been a hotly contested issue over the last several years. A new study suggests that 40 - not 50 - is the age to start having mammograms

Women who are diagnosed with breast cancer after mammography between the ages of 40-49 have a better overall outlook, according to new research.

"Discuss breast cancer screening with your gynecologist."

The study was conducted at the Swedish Cancer Institute and involved nearly 2,000 women.

"In our study, women aged 40 to 49 whose breast cancer was detected by mammography were easier to treat and had less recurring disease and mortality, because their cancer was found at an earlier stage," said Judith A. Malmgren, Ph.D., president of HealthStat Consulting, Inc.

Malmgren directed a research team that reviewed and analyzed information from a dedicated registry maintained by the Swedish Cancer Institute's community cancer center.

Researchers analyzed 18 years worth of data relating to 1,977 breast cancer patients aged 40 to 49 who were treated between 1990 and 2008.

The study examined how the cancer was detected (mammography, patient, physician), stage of the disease at the time of diagnosis, treatment, and follow-up information including recurrence and mortality.

Here's what they found:

  • Mammography-detected breast cancer increased from 28 percent in 1990 to 58 percent in 2008.
  • Patient- and physician-detected cancers declined from 73 to 42 percent over the same time period.
  • Compared to other detection methods, women whose breast cancer was discovered by mammography were more likely to have breast-conserving surgery (67 vs. 48 percent), less likely to have mastectomy (25 vs. 47 percent) and less likely to succumb to the disease (4 vs. 11 percent).

dailyRx asked Contributing Expert, Daniel B. Kopans, M.D., professor of radiology at Harvard Medical School, to comment on this study.

"This study is important 'frosting on the cake.' The only way to prove that screening saves lives is through randomized, controlled trials. These have shown that screening mammography for women ages 40-74 decreases the death rate from breast cancer by 25-30 percent, said Dr. Kopans, who is Senior Radiologist in the Breast Imaging Division at Massachusetts General Hospital Avon Comprehensive Breast Evaluation Center.

"Opponents of screening have suggested that screening leads to an increase in the use of mastectomies, when these data and other studies show that, in fact, earlier detection allows for a reduction in the need for mastectomy," said, Dr. Kopans, who was not involved in this study.

Addressing the recent controversies suggesting that breast cancer screening should start at age 50, Dr. Kopans told dailyRx: "There have never been any data to support the use of the age of 50 as a threshold for screening.

"None of the parameters of screening (recall rates, biopsy recommendations and cancer detection rates) change suddenly at the age of 50 or any other age. The randomized, controlled trials have always shown a decrease in breast cancer deaths for screening beginning at the age of 40," according to Dr. Kopans.

"This latest study reinforces the importance of mammography screening beginning at the age of 40," he concluded.

This study appears in the March, 2012 issue of Radiology.

The study was funded by the Kaplan Cancer Research Fund and the Cancer Surveillance System of the Fred Hutchinson Cancer Research Center.

No disclosure information was provided.

Last Updated:
February 22, 2012