番茄社区

CHICAGO – Annual screening with mammograms was beneficial in women ages 30-39 at high risk of breast cancer, researchers reported here.

Using data gleaned from the National Mammography Database, Cindy Lee, MD, of New York University Lang0ne Health in New York City, and colleagues, found a mean cancer detection rate of 3.7 per 1,000, among women who were considered at high risk for breast cancer – a rate that was about the same for women ages 40-49 who have average risk and are urged by medical societies to have mammography screening.

For women ages 30-39, "their cancer detection rate is very similar to women in the next decade of life who are being screened even though they have none of these risk factors," Lee said at the . "These two groups actually benefit equally from screening mammograms."

She recommended screening mammograms for the following groups of high-risk women in their 30s:

• Women with a personal history of breast cancer -- that is, they have already survived one bout of the disease
• Women with a family history of breast cancer -- a diagnosis of breast cancer in a mother, daughter, or sister
• Women with dense breast tissue, as determined by a previous mammography

For women in the analysis in the 30-39 age group, the recall rate – i.e., that there was something suspicious about their mammograms -- was 9.8%, Lee told 番茄社区.

"Women ages 30-39 with three specific risk factors should benefit by starting screening at age 30 instead of the age 40 start recommended for average-risk women," Lee said in her oral presentation. "We compared these women with risk factors with women in their 40s with no known risk factors who are recommended for a yearly screening. We wanted to know if we should start screening these high-risk women earlier than age 40."

"What this means is that if we are screening the women ages 40-49 with no risk factors, we should be screening the younger women with risk factors, because these younger women have more to lose in quality of years of life," Lee said.

The researchers analyzed results from the national database, which is housed at the American College of Radiology, identifying 2.6 million women across the U.S. who had 5.7 million mammograms in the period of January 2008 to December 2015. All the women in the study were asymptomatic for breast cancer.

"We support the idea that, as the American College of Radiology recommends, every women by the age of 30 should be assessed for risk of breast cancer," Lee said. "You should go to your primary care doctor, your ob/gyn, and talk to them about cancer risk factors. If you have enough risk factors, then you should really start screening to see if you have dense breasts, which would give you another risk factor. You would then belong in this younger, risky group and you should get screening mammograms."

Lee said the bottom line of her study is that if a woman has risk factors, she should be screened: "We are finding cancers in this group and we are finding them at an earlier enough date that we can save lives – and these are younger lives as well," she said.

When asked for his opinion, Gary Whitman, MD, of the University of Texas MD Anderson Cancer Center in Houston, said that the findings are not surprising. "In women who are 30-39 and have a personal history of breast cancer, I definitely would recommend that they have screening mammograms. If they have a family history of breast cancer, it would depend upon who in the family had breast cancer and at what age they had the disease, but if it was a first-degree family member with premenopausal breast cancer then it would be likely we would begin screening mammography earlier," he told 番茄社区."

Whitman noted that many women who are eligible for mammography are not being screened – probably in the 50% range, and that might be due to various reasons including primary care doctors who are looking at various guidelines that may not recommend yearly mammographies.

"Yet, we know that if we do mammography, we know that it saves lives; if we start at 40, we know that is the best way to have the greatest mortality reduction," Whitman said. "We don't have great data on younger women, but this paper by Dr. Lee and colleagues gives us some good data that patients who are in their 30s with the three specific risk factors would gain benefit by starting mammography at age 30."

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