A new study large-scale & # 39; more than 5 million annual screening mammogram found that mammography starting at age & # 39; 30 years can & # 39; & # 39 has; benefit women with & # 39; at least one of three specific factors & # 39; hazard: dense breasts, personal history & # 39; breast cancer or a family history & # 39; breast cancer. The study will be presented today at the annual meeting of the Radiological Society & # 39; American & # 39; America (RSNA).
Mammography is the examination of the standard images for breast cancer screening. The American Society of Cancer says that women should have the option to get an annual mammogram beginning at age & # 39; 40 years and recommends that all women with & # 39; medium risk will be examined year starting at age & # 39; 45. Some other key professional groups recommend annual mammography screening starting at age & # 39; 40 years, and RSNA support this recommendation.
However, for younger women, directives are less clear.
"Women under 40 were not the focus of our attention when it comes to breast cancer screening", said Cindy S. Lee, MD, assistant professor of & # 39; radiology at & # 39; NYU Langone Health in New York City. "Everyone is talking about a range of & # 39; 40-49, and not over & # 39; aged between 30 and 39. It is difficult to study this because most group women in & # 39; this band & # 39; age do not get mammograms, but some of these young women have an increased risk for breast cancer and can & # 39; need screening earlier and / or supplementary. "
For the study, Dr. Lee and colleagues compared the metrics of screening mammography performance in & # 39; women between 30 and 39 years old with three specific features of & # 39; against risk women, ages 40-49 without these factors & # 39; risk, Database (NMD), the largest source of & # 39; & # 39 examinations; screening mammography in the United States. The NDA contains data from more than 19 million mammogram, including patient self reported demographics, clinical findings, mammographic interpretations and bijopsji results.
The researchers analyzed data from more than 5.7 million mammogram of & # 39; screening performed on more than 2.6 million women over & # 39; eight years between January 2008 and December 2015 in & # 39; 150 is located across 31 states in the United States. The team & # 39; research comparing the measurement of screening performance among subgroups of & # 39; women based on age, the & # 39; risk factors and breast density.
Three specific features of & # 39; risk of breast cancer were evaluated in & # 39; this study: family history & # 39; breast cancer (any relative & # 39; first grade regardless of age), personal history & # 39; breast cancer and dense breast.
"Current models & # 39; breast risk prediction include factors & # 39; different risk, weighed b & # 39; a different way and can produce different results for the same patient. This complexity can & # 39 , leading to confusion and uncertainty both for doctors and for patients ". "Our study defined" increase in breast cancer risk 'b & # 39; simpler and inclusive way. Any woman with large breasts, personal history or family history & # 39; breast cancer at any relative & # 39; first grade is considered to have increased risk. "
She added that breast density is a factor of & # 39; an important risk for breast cancer, but is excluded from all models & # 39; risk except one.
Four & # 39; & # 39 metric; performance for mammography screening were calculated for each age & # 39; patient group & # 39; risk: rate & # 39; cancer detection, rate & # 39; retirement, and positive predictive value for biopsy recommended (PPV2) and biopsy performed (PPV3). Rate & # 39; retirement is the percentage of & # 39; patients called back for testing & # 39; follow-up examination & # 39; screening. The PPV reflects the percentage of & # 39; cancers found among the examinations for which the biopsy was recommended or undertaken.
In the group under 40 group, some women had an increased risk or because of dense breasts, family history or personal history & # 39; breast cancer.
B & # 39; In general, women in the & # 39; aged 30-34 and 35-39 had similar rates & # 39; cancer detection, rate & # 39; retirement and PPVs. Rates & # 39; cancer detection was higher with & # 39; significantly in & # 39; & # 39 by women, at least one of three factors & # 39; assessed risk. Moreover, compared to & # 39; & # 39 females with an age group from 40 to 44 at average risk, screening & # 39; incidence (at least from pre-screening test) of women in their 30s b & # 39; at least one of the three & # 39; evaluate risk factors showed similar rates of & # 39; detection of cancer and & # 39; withdrawal rates.
"Women with & # 39; at least one of these three factors & # 39; risk may benefit from screening of & # 39; screening beginning at age & # 39; 30 years, instead of 40," Dr. Lee said.
Co-authors are Heidi Ashih, Ph.D., Debapriya Sengupta, M. B.S., M.P.H., Edward A. Sickles, M.D., Margarita L. Zuley, M.D., and Etta D. Pisano, M.D.