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Annual screening may benefit younger women with dense breasts
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Younger women with dense breasts may benefit from annual breast cancer screening, according to results of a comprehensive cohort study that involved nearly 1 million women.
Karla Kerlikowske, MD, of the department of epidemiology and biostatistics at the University of California, San Francisco, and colleagues from the Breast Cancer Surveillance Consortium (BCSC) conducted a prospective cohort study to evaluate screening mammography frequencies according to age, breast density and postmenopausal hormone therapy use.
Karla Kerlikowske
Data for 11,474 women with breast cancer and 922,624 women without breast cancer qualified for analysis. All women had received a mammography from 1994 to 2008 at facilities participating in the BCSC.
Calculations were made to determine the odds of advanced disease, large tumors(>20 mm in diameter) and 10-year cumulative probability of a false-positive mammography result.
Biennial mammography among women aged 50 to 74 years was not linked to increased risk for advanced disease or large tumors compared with annual screening. This result remained consistent regardless of breast density or hormone use.
Increased risks for advanced disease (OR=1.89; 95% CI, 1.06-3.39) and large tumors (OR=2.39; 95% CI, 1.37-4.18) were linked to biennial mammography compared with annual mammography in women aged 40 to 49 years.
The cumulative probability of false-positive results was more frequent in two groups of women in the annual mammography cohort: those aged 40 to 49 years (65.5%) and those who used estrogen plus progestogen (65.8%). This probability was lower among women aged 50 to 74 years who underwent biennial (30.7%) or triennial mammography (21.9%), and among those with scattered fibroglandular densities (17.4%) or fatty breasts (12.1%).
“When deciding whether to undergo mammography, women aged 40 to 49 years who have extremely dense breasts should be informed that annual mammography may minimize their risk of advanced-stage disease, but the cumulative risk of false-positive results is high,” the researchers wrote.
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