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Increased mammography screening linked to reduced treatment, recurrence in women aged 40 to 49 years
Malmgren JA. Radiology.2012;262:797-806.
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Increased mammography-detected breast cancer was associated with lower-stage disease detection resulting in reduced treatment and lower rates of recurrence in women aged 40 to 49 years, according to study results published in Radiology.
In 2009, the US Preventive Services Task Force did not recommend routine mammography screening for women aged 40 to 49 years, concluding that the benefit was small for women in this age bracket compared with older women, and that the benefits of screening were potentially outweighed by the harms of screening, including false-positive results. Several medical societies, however, did not change their recommendations for women to begin annual mammography screenings at age 40 years.
To analyze trends in detection method linked to breast cancer stage at diagnosis, treatments, and outcomes over time among women aged 40 to 49 years, researchers conducted a longitudinal prospective cohort study of women in this age group who exhibited primary breast cancer from 1990 to 2008 and were identified and tracked by a dedicated registry database (n=1,977). Specific data, including method of detection — patient-detected, physician-detected or mammography-detected — were also extracted from the patients’ charts.
“Our goal was to assess the differences between mammography and non-mammography detected breast cancer, to determine whether earlier detection confers a treatment and morbidity advantage because the disease is found at an earlier stage,” Judith A. Malmgren, PhD, said in a press release. “The shift toward more mammography-detected breast cancer cases was accompanied by a shift toward diagnosis at an earlier stage of disease that required less treatment.”
Data analysis demonstrated a significant increase in the percentage of mammography-detected breast cancer during the course of the study (28% to 58%), as well as a concurrent decline in patient- and physician-detected breast cancer (73% to 42%), with an overall increase in lower-stage disease detection and a decrease in higher stage disease.
Researchers determined that mammography-detected breast cancer patients were more likely to undergo lumpectomy (67% vs. 48% of patient/physician-detected breast cancer patients) and less likely to undergo modified radical mastectomy (25% vs. 47% of the patient/physician-detected breast cancer patients; P<.001).
“In our study, women aged 40 to 49 whose breast cancer was detected by mammography were easier to treat and had less recurring disease and mortality, because their cancer was found at an earlier stage,” Malmgren said. “The objective of screening is to detect disease at an earlier, more treatable stage, which — based on our review — mammography accomplishes.”
Disclosure: The researchers report no relevant financial disclosures.