Serious questions remain about how best to balance screening’s benefits with its potential harms, including false-positive test results, overdiagnosis leading to invasive treatment for non-life-threatening conditions, and repeated exposure to radiation.
hoosing when to start regular breast cancer screening is a complicated decision for individual women and their providers. For most women, increasing age is the biggest risk factor for breast cancer, which is much more common at age 60 than at 40. But two new articles on other risk factors may inform guidelines and clinical practice about screening mammography from age 40 to 49.
Should women start breast cancer screening at age 40 or 50? Every year or every other year? By mammography or breast MRI? As patients and physicians ask these and related questions, confident answers require solid evidence.
In 10 years of annual mammograms, more than half of women without cancer will be called back at least once for more testing. And about one in 12 will be referred for a biopsy, according to a study of national Breast Cancer Surveillance Consortium data in the Annals of Internal Medicine.
Changing policy could make screening for breast cancer more accurate
More women are surviving longer after having early-stage breast cancer, but they are at risk of developing breast cancer again: a recurrence or a new cancer, in either breast. Annual screening (a.k.a. “surveillance”) mammography has long been standard for these women, but only scant evidence on screening outcomes supported this practice. In the February 23, 2011 Journal of the American Medical Association, the most comprehensive relevant study to date shows yearly mammograms do detect second breast cancers early.