A large study strongly supports the value of regular mammogram screenings starting at age 40. From 1990 to 2008, while more women age 40 to 49 were getting screening mammograms:
- more breast cancers were diagnosed
- breast cancers tended to be diagnosed at an earlier and more treatable stage
- more women were eligible for lumpectomy instead of mastectomy
- treatment outcomes improved
The research was published in the March 2012 issue of Radiology.
In November 2009, the U.S. Preventive Services Task Force (USPSTF) recommended that routine screening mammograms for women with an average risk of breast cancer should start at age 50, instead of age 40. These recommended changes were very controversial and were not adopted. U.S. guidelines call for all women age 40 and older to have screening mammograms every year. While not ideal, some women may choose to have a screening mammogram every other year.
The study in Radiology looked at diagnosis, treatment, and outcome information from 2,000 women age 40 to 49 who were diagnosed with breast cancer between 1990 and 2008. All the women got their cancer care at the same medical center in Seattle, Wash.
During the same time period when the women were diagnosed, there were public campaigns to make women aware of the value of starting screening mammograms at age 40. So the number of women between age 40 and 50 getting screened went up, and more breast cancers were diagnosed by mammography. Mammogram-detected breast cancer was 28% of all diagnoses in 1990 and went up to 58% of all diagnoses in 2008.
The benefits of mammogram screening for younger women can be measured by a number of factors:
- Breast cancers were less likely to be advanced-stage at diagnosis: Advanced-stage breast cancers at diagnosis decreased from 24% in 1990 to 8% in 2008
- Compared to women with breast cancer detected by self-exam or doctor's exam, women with breast cancer detected by screening mammography were:
- more than 40% more likely to have lumpectomy instead of mastectomy to remove the cancer
- nearly 50% less likely to need chemotherapy
- 33% less likely to have the cancer come back (recur) 5 years after diagnosis and 42% less likely to have a recurrence 10 years after diagnosis
- more likely to survive breast cancer
Taken together, the results strongly suggest that breast cancer screening starting at age 40 leads to diagnoses of breast cancer at earlier, more treatable stages. Other studies have shown that regular screening starting at age 40 means better prognoses for women diagnosed -- and lives saved. Despite that evidence and the current guidelines, many women age 40 to 49 don't get regular screening mammograms.
If you're 40 or older and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. If your breast cancer risk is higher than average, you may want to talk to your doctor about a more aggressive breast cancer screening plan that makes the most sense for your particular situation.
There's only one of you and you deserve the best care possible. Don't let any obstacles get in the way of regular screening mammograms.
- If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
- If you're having problems scheduling a mammogram, call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
- If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.
For more information on mammograms and other tests to detect breast cancer, visit the Breastcancer.org Breast Cancer Tests: Screening, Diagnosis, and Monitoring pages.