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2 Breast-Cancer Studies Say Screening Works

November 19, 2010
Written by: , Filed in: Breast Imaging
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Two new European studies involving women with breast-cancer risk factors support the efficacy of mammography screening for women in their 40s with a family history of breast cancer and of MRI screening for medium- to high-risk women at any age.

A study published online Thursday in The Lancet Oncology looked at 6,710 United Kingdom women ages 40–49 with family histories of breast cancer. They were screened with annual mammograms for an average of four years, compared to the usual National Health Service practice of screening every three years starting at age 50.

The researchers compared the screened group to women in two control groups who had not received screening. Tumors found in the screened group were significantly smaller, less likely to be node-positive, and at an earlier stage than tumors that were found in the control groups.

The study concludes: “Our data suggest that, in women younger than 50 years who are at medium or greater familial risk of breast cancer, mammographic surveillance could increase cancer detection, reduce the risk of advanced stage disease, and decrease predicted mortality.”

However, the authors caution that increased screening also brings risks of greater patient anxiety as well as radiation exposure and false positives resulting in unnecessary surgery.

The other study, published online earlier this week in the Journal of Clinical Oncology, followed 2,157 Dutch women for five years. The women, ranging in age from 25 to 75, had never had breast cancer but either had family histories of the disease or carried the high-risk BRCA1 or BRCA2 mutation. They were screened with biannual clinical breast examinations and annual mammography and MRI.

The study found that sensitivity at detecting breast cancer was 71 percent with MRI and 41 percent with mammography. For BRCA1 carriers, MRI beat mammography 67 percent to 25 percent.

The New York Times, reporting on the study results, said the study might lead some high-risk women to opt for intensive screening including MRI rather than having their breasts removed as a preventive measure.

“Carefully screened with MRI, clinical breast examination, and mammography, even women at high risk for the development of breast cancer may make a rational decision not to have prophylactic mastectomy as a risk-reducing intervention,” said Andrew D. Seidman, MD, a breast cancer specialist at Memorial Sloan-Kettering Cancer Center, who was not involved in the study.

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