LONDON (Reuters) - Screening women under 50 years old for breast cancer does not significantly reduce deaths from the disease, British researchers said on Friday.
They estimated giving women annual mammograms beginning at the age of 40 could save about four lives for every 1,000 women screened.
But they added the benefit must be weighted against increased radiation exposure, which could raise breast cancer risk, anxiety caused by false positive results and higher costs for the screening programs.
"This trial did not find a significant reduction in breast cancer mortality in women offered annual screening between the ages of 40 and 48 years," said Dr. Sue Moss of the Institute of Cancer Research in London.
She added the results of the research, published in The Lancet medical journal, are consistent with the findings of previous studies that analyzed the risks and benefits of screening women under 50 years old for breast cancer.
The disease, the leading cause of cancer in women, occurs most in the over-50s. In Britain, women ages 50-70 are invited for annual screening but in some other countries screening is advised for younger women.
Moss and her team assessed the impact of screening younger women in a 10-year study. More than 160,000 women in Britain were randomly selected to have annual mammograms from the age of 40 or from 50 years old.
Although cancer deaths in the younger screening group dropped compared to deaths in those screened later, it was not statistically significant, according to the researchers.
Twenty-three percent of women who had regular mammograms from 40 had at least one false positive result, compared to an estimated 12 percent in the older group.
"Longer follow-up of this trial will provide further information. It is important that all the potential advantages and disadvantages of screening are taken into account when considering any changes in policy," Moss added.
Robert Smith, the director of cancer screening at the American Cancer Society, said the results of the study do not substantively call into question the value of mammography for women in their 40s.
"Current evidence supporting mammograms is even stronger than in the past. In particular, recent evidence has confirmed that mammograms offer substantial benefit for women in their 40s," he said in a statement.
But Professor John Toy, of the charity Cancer Research UK which funded the trial, said it showed no definitive evidence for women in their 40s to be included in screening programs.
"We encourage women of all ages, and particularly older women in whom breast cancer is more common ... to see their doctor straight away if they notice any changes in their breasts," he said in a statement.
The study reviewed here is not the first, and won't be the last, to question the current recommendation that mammograms should start at age 40. The researchers suggest that starting at age 50 may make more sense.
Recommendations on when to get mammograms take into account the risks and benefits for ALL women. But each woman is a unique person, not a statistic. And each woman wants to do what makes sense for HER. The researchers report that four out of 1,000 women could have their lives saved by mammograms that started at age 40 instead of 50. For those women, screening starting at age 40 is very important.
Though less common, breast cancer does occur in women younger than 50. Many times breast cancer in younger women is more aggressive. Finding breast cancer early when it's most treatable gives you and your doctor more treatment options and most likely a better prognosis. So why even question the current guidelines? The researchers note two good reasons:
Until we know more, breastcancer.org supports the current recommendation that women get a mammogram once a year, starting at age 40. If you feel that starting at a later age makes sense for you, talk to your doctor and decide together the approach that's best for you. If you're at high risk for breast cancer, with a strong family history of breast or ovarian cancer, or have had radiation treatment to the chest in the past, you should discuss having annual mammograms before age 40 with your doctor.
No matter when you first start to get annual mammograms, remember that more than mammography is needed. Women also need to practice breast self-examination, get regular breast examination by an experienced health care professional, and, in some cases, also get another form of breast imaging, like ultrasound or MRI scanning. It's also important to tell your doctor immediately if you feel a lump in your breast during self-examination.
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