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Mammograms For Ages 40-49 Get A Boost

September 30, 2010
Written by: , Filed in: Breast Imaging
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Last week we heard about a Norwegian study that found only minimal benefit from regular mammography screening in women age 50 or older. This week comes a population-based study from Sweden finding significant benefit from mammography screening for women ages 40 through 49.

Next week, who knows?

The latest study, published online Wednesday in the journal Cancer, was directed by Umeå University in Umeå, Sweden. You can’t argue with the sample size: it encompassed Sweden’s entire female population in that age group—about 1 million women altogether during the years of the study.

For several years, about half of Sweden’s counties and cities called in women for regular mammography screening starting at age 40 and the other half started regular screening at 50. That quirk created both a mammogram group and a control group for ages 40 through 49.

The researchers followed the women for an average of 16 years. They found that inviting women to begin regular mammograms at age 40 rather than 50 reduced the risk of death from breast cancer by 26 percent. When the researchers looked only at women who actually got screening mammograms (excluding those who declined the invitation), the risk of death was reduced by 29 percent.

To put the findings another way: to save one life, 1,250 women would have to be screened every other year from age 40 through 49.

Jennifer Obel, MD, moderated the press briefing at which the findings were announced. It took place in advance of a presentation at the American Society of Clinical Oncology (ASCO) Breast Cancer Symposium in National Harbor, Maryland. According to MedPage Today, Dr. Obel, a member of the ASCO communications committee, told reporters:

One thing is certain. Mammography has been shown in study after study to reduce the risk of breast cancer in women 40 to 49. What we’re talking about is the debate about how many women need to be screened to save one life.

MedPage Today and Associated Press medical writer Marilynn Marchione noted some limitations of the study. It couldn’t guarantee that the mammography group and the control group were comparable in terms of health or other factors, for example, nor did it address the harm of such mammography drawbacks as false positives.

However, Håkan Jonsson, PhD, of Omeå University also pointed out that the new study, which looked at data beginning in 1986, was more recent than the studies that led the U.S. Preventive Services Task Force last fall to recommend against routine screening for women in their 40s. Dr. Jonsson noted that screening techniques and cancer treatment have improved in recent years, which could have improved the effectiveness of screening.

Neither Dr. Jonsson nor Dr. Obel went so far as to unequivocally recommend that screening start for everyone at age 40. Instead, Dr. Obel said it was still best for patients and their doctors to make decisions based on the circumstances of each individual case.

Related seminar: Women’s and Breast Imaging

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