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Breast Cancer Deaths in Younger, Unscreened Women

Mammograms should begin at age 40, researcher says
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Women were described as unscreened if they had never had a mammogram or it had been more than two years since their last mammogram.

The findings confirmed the benefits of earlier screening, some experts said.

"[The study] presents a very compelling argument in favor of screening beginning at age 40 on an annual basis," said Dr. Barbara Monsees, chairwoman of the American College of Radiology Breast Imaging Commission, who was not involved in the research. "It corroborates what we have known for a long time."

Overall, the study also showed an increase in breast cancer survival coinciding with the emergence of mammography. Half of women diagnosed with breast cancer in 1969 died within 13 years after diagnosis, compared to about 9 percent of those diagnosed between 1990 and 1999 who were included in this study.

Although some experts have credited the decline in breast cancer death rates to improved treatments, the study shows that's not the whole story, Monsees said. "This paper shows the decline is primarily due to earlier detection and better screening," she said.

Frequent screening is even more important in younger women than in older woman, she added. Tumors in older women typically grow slower than in younger women.

The bottom line: "Screening doesn't reduce the risk of getting breast cancer, but it does reduce the risk of dying from it," Monsees said.

Robert Smith, director of screening for the American Cancer Society, offered this perspective: "Regular screening was associated with a much, much lower likelihood of dying [from breast cancer]," compared to no screening or long-ago screening.

One-third of deaths among those who did get screened regularly were attributed to "interval cancers," those detected in between the mammograms done every two years. Although this shows that getting regular mammograms doesn't entirely eliminate the risk of dying from breast cancer, Smith said, "the message here is that mammography is a good part of your prevention plan."

If the cancer is detected early, options for breast-conserving surgery are greater and the risk of dying from the cancer is reduced, he said.

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