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Biennial mammogram may be effective for some women
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Women who underwent mammograms every 2 to 3 years demonstrated a reduced cumulative risk for false-positive results than those who underwent annual screening, according to study results.
“However, elevated risks of late-stage disease in Hispanic women and lymph node-positive disease in younger Asian women who screened less often than annually warrant consideration and replication,” Ellen S. O’Meara, PhD, a research associate with Group Health Research Institute in Seattle, and colleagues wrote.
Ellen S. O’Meara
Prior studies have suggested that biennial mammography screening is associated with most of the same benefits as annual screening but with reduced harms. However, it is unknown whether screening guidelines based upon ethnicity and age may be more effective than age-based guidelines alone.
For this reason, O’Meara and colleagues gathered data from the Breast Cancer Surveillance Consortium and compared with data from pathology and tumor databases. The study cohort included women aged 40 to 74 years who underwent annual, biennial or triennial mammogram screening between 1994 and 2008.
Logistic regression assessed the adverse tumor characteristics for 14,396 incident breast cancer cases, as well as 10-year cumulative risk for false-positive recall and biopsy recommendation among nearly 1.3 million noncases.
Results indicated there was no increase in the risk for adverse tumor characteristics among white, black or Hispanic women aged 40 to 49 years, or among Asian women aged 50 to 74 years, who underwent biennial screening when compared with women who underwent annual screening.
Conversely, researchers reported an increased risk for late-stage disease (OR=1.6; 95% CI, 1.0-2.5) and large tumors (OR=1.6; 95% CI, 1.1-2.4) among Hispanic women aged 50 to 74 years who underwent screening biennially vs. annually. Additionally, Asian women aged 40 to 49 years who underwent biennial screening were at increased risk for positive lymph nodes (OR=3.1; 95% CI, 1.3-7.1).
A longer screening interval was associated with a considerable decrease in cumulative false-positive risks, defined as the probability of one false-positive result after 10 years of subsequent mammography.
“The cumulative risk of false-positive recall was found to be highest in black and white women aged 40 to 49 years (65% of annual, 41% of biennial and 29% of triennial screeners in both groups) and lowest in Asian women aged 50 to 74 years (47%, 29% and 20%, respectively,” O’Meara and colleagues wrote. “The cumulative risk of a false-positive biopsy recommendation was highest in black women aged 40 to 49 years (13% of annual, 7.2% of biennial and 4.7% of triennial screeners) and lowest in Asian women aged 50 to 74 years (6.4%, 3.5% and 2.5%, respectively).”
When the researchers compared triennial screening with biennial screening, they observed no increased risks.
Disclosure: The researchers report grant support from NCI, the National Human Genome Research Institute and the University of Vermont.
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