Age 50 as mammography screening threshold proven unfounded
The landmark breast cancer screening study of women 40-49, published online in Cancer, has proven that annual mammography screening of women in their 40s reduces the breast cancer death rate in these women by nearly 30 percent. The results of this largest study ever conducted on women in this age group confirm that the use of the age of 50 as a threshold for breast cancer screening is scientifically unfounded. Women should begin getting annual mammograms at age 40.
"This study, which looked at the performance of screening mammography as it is actually used, rather than relying on mathematical modeling, shows without a doubt that mammography decreases deaths from breast cancer in women aged 40-49 by nearly one third. There is no excuse not to recommend that average risk women begin annual screening mammography at age 40," said Carol H. Lee, MD, Chair of the American College of Radiology Breast Imaging Commission.
In Nov. of 2009, the United States Preventive Services Task Force (USPSTF) ignored published data showing a similar death rate reduction to this landmark trial, and withdrew support for screening women 40-49. This real world study is far more robust, based on real world numbers, and proves that the benefit is nearly twice that of the USPSTF estimate of 15 percent.
"This study shows that annual mammograms for women 40 and over result in a tremendously significant reduction in the breast cancer death rate for women 40-49. The age of 50 is an artificial threshold that has no basis in scientific fact. The debate is now over. Women should no longer be confused about the importance of annual breast cancer screening. Mammography saves lives. If you are a woman age 40 or over, one of them could be yours," said Phil Evans, MD, President of the Society of Breast Imaging (SBI).
The Swedish trial followed more than 600,000 women for 16 years. The number of breast cancer deaths among the women in the study who did not receive mammograms was twice as high as those who underwent screening. Breast cancer is the most common cancer in women worldwide. It kills around 465,000 people globally each year. Mammography can catch cancer early, when it is most treatable. While not a perfect test, at present, there is no other screening tool to replace it.
"It is now time to stop confusing women with conflicting information. Mammography is a lifesaver for women in their 40s. What providers need to do now is uniformly confirm for women that they need to start getting annual mammograms beginning at age 40 and work to build on the ability of mammography to detect cancer early, when it is most treatable. Mammography saves a significant number of lives in all women 40 and over. Let's all move forward from there," said Gail Lebovic, MD, breast surgeon and President of the American Society of Breast Disease (ASBD).
