Annual mammograms may be necessary beyond 40: Study

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According to a latest study, women, even without family history of breast cancer, should undergo cancer screening or a mammography every year after reaching the age of 40.

The study was revealed Wednesday at the annual meeting of Radiological Society of North America (RSNA). The study says women in their 40s with no family history of breast cancer are as likely to develop invasive breast cancer as are women with a family history of the disease.

There has been a debate on frequency of mammograms after 40. Earlier the US Preventive Services Task Force (USPSTF) had recommended that regular breast cancer screening of women should start at the age of 50 as opposed to 40.

“We believe this study demonstrates the importance of mammography screening for women in this age group, which is in opposition to the recommendations issued by the taskforce,” said Stamatia V Destounis, radiologist and managing partner of Elizabeth Wende Breast Care, Rochester who led the study.

Dr. Destounis and colleagues reviewed the number and type of cancers diagnosed among women in 40-49 age group - with and without a family history of breast cancer-who underwent screening mammography at Elizabeth Wende Breast Care between 2000 and 2010. The researchers compared the number of cancers, incidence of invasive disease and lymph node metastases between the two groups.

They looked at 1,071 patients in the 40-49 age group suffering from breast cancer. Of these 373 were diagnosed due to screening. Of that 373, 39% had a family history of breast cancer. In the family history group, 63.2 % of the patients had invasive disease. In the no-family history group, 64 % of the patients had invasive disease. The lymph node metastatic rates were 31% and 29 %, respectively.

Dr. Destounis said, “In the 40-49 age group, we found a significant rate of breast cancer and similar rates of invasive disease in women with and without family history… Additionally, we found the lymph node metastatic rate was similar.” Dr. Destounis added that the results underscore the importance of early detection and annual screening mammography for women in the 40-49 age group, irrespective of a family history of breast cancer.

The global analysis that factored in the trend over the past three decades shows the number of new breast cancer cases diagnosed worldwide has increased dramatically from about 640,000 in 1980 to 16,00,000 in 2010. On the contrary, the rise in deaths from breast cancer globally has been slower, increasing from about 250,000 in 1980 to 425,000 in 2010, possibly reflecting the effectiveness of early detection and advances in treatment in developed countries. The study was published in the British medical journal The Lancet.

More than 230,000 women will be diagnosed with breast cancer in the U.S. in 2011, more than 26,000 of who will be under age 45, according to the American Cancer Society. The American Cancer Society and the National Cancer Institute both continue to recommend annual screening beginning at age 40, however, leading to confusion among doctors and patients, Destounis says.

The new findings are unlikely to put an end to the debate, says Edith Perez, a breast cancer specialist at the Mayo Clinic in Jacksonville, Fla. What they do suggest, she tells WebMD, is that family history is not useful for deciding which younger women would benefit from annual screening mammograms.

Screening recommendations are aimed at the general population, not the individual patient, explained Claudine Isaacs, director of the clinical breast cancer program at Georgetown's Lombardi Comprehensive Cancer Center in Washington, D.C. “This is an area of considerable controversy and, as always, it is best for women to check with their own doctors,” she told WebMD.

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

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