There is solid evidence that screening mammography for women 50 years and older significantly reduces breast cancer mortality. The major controversy in mammography screening is what age to start screening. Some national organizations recommend starting at age 50 years and others recommend starting at age 40 years. (Please note: high risk women; i.e. those with strong family histories should consult their physicians for screening guidelines).
The journal Cancer recently reported on a 25 year follow-up of a Swedish study of women who underwent mammography screening between the ages of 40-49 years. The study was an outgrowth of the pioneering work of Dr. Laszlo Tabar who is an international authority on breast cancer screening and value of mammography.
In brief, this new study clearly demonstrates a 29% reduction in breast cancer mortality for women ages 40-49 who underwent mammography screening as compared to women who were not invited to be in the screening study. The actual results may be better since women who were not invited to participate could have paid out of pocket for a screening mammogram and still be included in the not invited to screening population.
These findings should be of great importance to women under 50 years since recent recommendations from the US Preventive Service Task Force (USPSTF) recommended that routine screening was not indicated for this age group. The USPSTF concluded that screening should be an individual choice.¹
In essence, I do agree with the USPSTF guidelines that screening in this age group should be an individual choice. Given the most recent study results from Sweden, it seems that the most logical choice would be for these women to do yearly mammography screening starting at age 40. If you have any question or concerns be sure to contact us.
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¹ In conclusion, the current large study of the Swedish service-screening program with mammography for women ages 40 to 49 revealed a reduction in breast cancer mortality. The reduction was estimated at 26% to 29%, depending on the studied exposure. The reduction was greater only when those women who actually attended screening were considered, and it also was greater among women ages 45 to 49 years than among women ages 40 to 44 years.
In the United States, the US Preventive Services Task Force (USPSTF) recently changed its guidelines and no longer recommends screening for women ages 40 to 49 years; instead, the USPSTF argues that screening for women in this age group should be an individual choice. See reference: “Effectiveness of population-based service screening with mammography for women ages 40 to 49 years.”
