Neglecting Breast Cancer Screening in Women Aged 40 to 49 Impacts Diagnosis

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(ChemotherapyAdvisor) – Gynecologists should not forgo mammography in women aged 40 to 49, according to a group of researchers of Case Western Reserve School of Medicine, Cleveland, OH. The study, “Neglecting to Screen Women between the Ages of 40 and 49 Years with Mammography: What Is the Impact on Breast Cancer Diagnosis?” which will be published in the May issue of the American Journal of Roentgenology.

The investigators aimed to compare breast cancer stage at diagnosis in two groups of women between 40 and 49 years old: women undergoing screening mammography and women with a symptom needing diagnostic workup. “This comparison is indicative of the impact of forgoing screening in this age group, as recommended by the United States Preventive Services Task Force,” noted the investigators.

Retrospective data were collected from imaging-guided core needle biopsies performed in women between the ages of 40 and 49 years during the time period: January 1, 2008, to December 31, 2009. The investigators also recorded, for all patients diagnosed with breast cancer or a high-risk lesion, the reason for presentation, pathology, tumor size, stage, and receptor characteristics. Data were analyzed by chi-square testing.

The investigators reported 108 primary breast cancers: 71 in the screened group, 37 in the unscreened group. Ductal carcinoma in situ was more likely to be diagnosed in the screened group than in the unscreened group (22 vs. 1, chi-square=11.6, P=0.001) and more likely to be diagnosed at earlier stages (chi-square=5.02, P=0.025). “The size of invasive breast cancer in the screened group was significantly smaller as well (chi-square=9.3, P=0.002). Of the high-risk lesions, atypical ductal hyperplasia (n=29) and lobular carcinoma in situ (n=8) were most frequently seen,” the investigators wrote.

The investigators concluded: “Breast cancer patients undergoing screening mammography were diagnosed at earlier stages with smaller tumors. Screening also allows detection of high-risk lesions, which may prompt chemoprevention and lower subsequent breast cancer risk. We continue to support screening mammography in women between the ages of 40 and 49 years.”

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