May 2, 2012
More Benefits Than Risks In Mammograms For AT-risk Women In Their 40s
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Researchers recently found that there are more advantages than disadvantages related to breast screening mammograms for women in their 40s who have a higher risk of having breast cancer. The report also states that digital mammography provides more harm than good when compared to film mammography.
The study pulled data from the Breast Cancer Surveillance Consortium (BCSC), the Cancer Intervention and Surveillance Modeling Network (CISNET), and the Oregon Evidence-based Practice Center in hopes of providing more information on breast cancer screenings to women throughout the country.
The research, published in the May 1 issue of Annals of Internal Medicine, discusses factors that can increase breast cancer risk. Women who have a greater risk of developing the illness include those who have dense breasts, found in 13 percent of the population between the ages of 40 to 49, and those who have a first-degree relative who has had breast cancer, found in 9 percent of the population between the ages of 40 to 49. Researchers defined benefits of screening as breast cancers deaths avoid and life-years gained after diagnosis. On the other hand, harms are seen as false-positive mammography exams that can cause patients to have anxiety, pain, and more invasive procedures.
"Our research suggests the benefit-harm balance is tipped in favor of every-other-year screening for women in their 40s who are at about twice the average risk of developing breast cancer," noted the study's senior author Dr. Jeanne Mandelblatt, who works as an associate director for population sciences at Georgetown Lombardi Comprehensive Cancer Center. "The study also determined that the balance of benefits and potential harms in this same group is not favorable when increasing the frequency of mammography screening to once a year."
With varying degrees of breast density and family history of breast cancers, health organizations in the past decided it was best to recommend a baseline mammography for female patients. Mammograms were first recommended to be done every two years for women between the ages of 50 and 74 by the U.S. Preventive Services Task Force (USPSTF) in 2009. USPSTF also states that it is up to the individual if they want to start having regular breast exams before the age of 50.
“For example, the need to have a mammogram to determine breast density is an important point to consider in regards to implementing risk-based guidelines based on breast density,” explained Mandelblatt in the statement.
Earlier research showed that the biennial screenings were helpful, but also had certain harms like a small dose of radiation or making patients undergo unnecessary treatment.
"The fog is clearing," commented Dr. Diana Petitti, who worked on the 2009 Preventive Services Task Force study, in a Medical Xpress article. "Personalized breast screening recommendations are better."
The new research also shows that digital mammography can cause more harm than film mammography. Digital mammography had more false-positive results than film, which created more anxiety in patients. Mandelblatt states that the new findings on screenings are based on groups of females in the U.S. and, while not recommendations for individual women, they can act as guidelines for groups who advise females on breast cancer screenings.
"These results are not intended to guide clinical care, but to provide evidence to groups striving to individualize screening guidelines based on risk factors," commented Mandelblatt in the statement. "Ultimately, though, the decision of when to start screening and how often, and whether to have digital or film mammography should be left to women and their health care providers."
According to a Reuters report, health professionals believe that the new research shows the need for screenings based on patient context and personal history.
"Risk-based screening can refocus efforts onto the women who are most likely to benefit from screening,” wrote Dr. Otis Brawley, Chief Medical Officer at the American Cancer Society, in an article that accompanied the studies in the medical journal.
Otis Brawley also states that, while mammograms are important, self-screening is just as vital.
"I worry that we are not encouraging women as much to have breast awareness. If you find something in your breast, go get it checked out right away," he said in an interview with ABC News.