You're at High Risk of Breast Cancer

Breast cancer screenings should start in your 40s according to new study

(RxWiki News) Start mammography at age 40. No, make it 50. Oh hell, if you don't feel like it - don't have a mammogram at all. So, are you confused? Well don't be.

The most recent research says it's virtually impossible to determine breast cancer risks.

A new study has shown that women in their 40s have similar risks for developing invasive breast cancer as women with a family history of the disease. And the take-away message is that mammography should begin in your 40s.

"Ask your doctor how often you should be screened for breast cancer."

The confusion and controversy were ignited when the U.S. Preventive Services Task Force (USPSTF) issued guidelines in 2009 recommending against mammograms for women in their 40s unless they have a family history of breast cancer.

For this new study, Stamatia V. Destounis, M.D., radiologist and managing partner of Elizabeth Wende Breast Care in Rochester, New York, and colleagues analyzed the types of cancers diagnosed in women, aged 40-49, who underwent mammography at the facility between 2000 and 2010.

Some of the women had a family history of breast cancer and some did not. Participants were assigned to two groups based on their family history.

Researchers compared the number of cancers diagnosed, incidence of invasive breast cancer and lymph node metastases (spread) seen in the two groups. Here's what they found:

  • Of the total 1,071 women in the study, 373 were diagnosed with breast cancer detected with screening.
  • Of the breast cancer patients, 39 percent had a family history, and 61 had no family history of the disease.
  • Invasive disease was found in 64 percent of the patients with a family history.
  • Lymph node involvement was seen in 31 percent of women with a family history, and 29 percent with none.

dailyRx spoke with one of our Contributing Experts, Cary Kaufman, M.D., a breast surgeon and specialist at Bellingham Regional Breast Center in Washington state, about the implications of this new study. "Doctors who specialize in diagnosing breast cancer have known that they cannot predict who will develop breast cancer," he said.

"This study demonstrates that the USPSTF recommendation to use personal risk for breast cancer to determine mammography use is fundamentally flawed. This study found women between 40-49 years old develop 18% of all breast cancers and are diagnosed with screening mammograms in one third of cases," Dr. Kaufman said.

So, it's impossible to determine high-risk groups, according to Dr. Kaufman. "Patients who would be expected to be high risk (those having a family history of breast cancer) were diagnosed with breast cancer no more frequently than the average woman without a family history. Also the type and severity of breast cancer was no different in high risk women versus those of average risk."

Dr. Kaufman concludes, "This study gives support that all women above age 40 should have the benefit of routine screening mammography to save lives."

Findings from this study were presented at the annual meeting of the Radiological Society of North America (RSNA).

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Review Date: 
November 29, 2011