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Studies Point to Reasons for Mammograms in 40s

Women With Dense Breasts or a Family History of Breast Cancer May Want to Consider Screening in Their 40s
By
WebMD Health News
Reviewed by Louise Chang, MD

patient undergoing mammogram

April 30, 2012 -- A pair of new studies aims to clear up some of the confusion over what age women should start getting routine mammograms to screen for breast cancer.

The studies, which are published in the Annals of Internal Medicine, show that a woman in her 40s who has extremely dense breasts, or who has a mother or sister with breast cancer, reaps the same benefits and drawbacks from getting regular mammograms as a woman in her 50s.

Researchers say that meets a "threshold of risk" that may help guide women and their doctors to start regular mammograms at age 40 instead of age 50, as some current guidelines suggest.

"They're really taking a better look and saying if you have risk factors, you should be screening at age 40 because then the benefit is there," says Stephanie Bernik, MD, chief of surgical oncology at Lenox Hill Hospital in New York City.

Bernik says she was relieved to see the new studies because she felt guidelines issued in 2009 that recommended that most women wait until age 50 to start getting regular mammograms were premature and might discourage some younger women who could benefit from the tests.

"This is better than what they said before," says Bernick, who was not involved in the research.

But for some researchers, it's still not enough. Since the research is preliminary and is meant more for policy makers than for individuals, one researcher called it "ivory tower" information that still isn't intended to help a younger woman make a decision.

Refining Recommendations on Mammograms

In 2009, the U.S. Preventive Services Task Force (USPSTF) said that most women should get routine mammograms every two years starting at age 50 instead of age 40.

That recommendation conflicts with guidelines from the American Cancer Society, the National Cancer Institute, and the American College of Radiology, which all recommend screening starting at age 40. And it has drawn mixed reactions from patients and doctors.

Some groups applauded the conservative approach, saying that it would reduce the harms of over-testing and overtreatment, which are greatest for women in their 40s.

Others said it would unnecessarily put women's lives at risk, since cancers found in younger women can be aggressive and early detection of an aggressive cancer may be a woman's best hope for survival.

Ultimately, the USPSTF said the decision to start breast cancer screening before age 50 should be left up to individual women and their doctors.

But until now, there's been little information to help guide that decision.

Family History or Dense Breast Tissue Doubles Risk

The new studies, which were conducted by the same group of researchers that compiled the evidence for the 2009 USPSTF recommendations, are meant to help clarify when mammograms might be useful for younger women.

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