CHICAGO, 28 November 2018 A new large-scale study with more than 5 million mammograms found that an annual mammogram beginning at the age of 30 may benefit women with at least one of three specific risk factors: dense breasts, a history of breast cancer, or a family history of breast cancer. The study will be presented today at the Annual Meeting of the Radiological Society in Prague North America (RSNA).
Mammography is a standard imaging examination for breast cancer screening. The American Cancer Society claims that women should be able to choose an annual mammogram beginning at the age of 40, and recommends that all women with an average risk be investigated annually from the age of 45. Some other leading professional groups recommend annual mammographic screening starting at the age of 40, and RSNA supports this recommendation.
For younger women, however, the guidelines are less clear.
"Women under the age of 40 were not in our attention when it comes to screening breast cancer," he said Cindy S. Lee, M.D., radiology assistant at New York City. "Everyone is talking about 40-49 and not 30-39. It's hard to study this group because most women in this age range do not have mammography, but some of these young women have an increased risk of breast cancer and may require earlier and / or supplementary screening. "
For the study of Dr. Lee and colleagues compared the performance metrics of screening mammography in women aged 30 to 39 with three specific risk factors versus women aged 40-49 without these risk factors using data from the National Mammographic Database (NMD), the largest source of screening mammography results in The US NMD contains information from over 19 million mammograms, including patient demographics, clinical findings, mammographic interpretations and biopsy results.
Researchers analyzed data from more than 5.7 million screening mammograms performed on more than 2.6 million women between eight years January 2008 and December 2015 in 150 facilities in 31 states in the United States. The research team compared performance screening metrics among women's subgroups on the basis of age, risk factors and breast density.
Three specific risk factors for breast cancer have been evaluated in this study: a family history of breast cancer (any first-degree relative regardless of age), a history of breast cancer and dense breasts.
"Current risk-prediction models include a variety of risk factors that are different and can produce different outcomes for the same patient, which can lead to confusion and uncertainty for both doctors and patients," Dr. "Our study defined an" increased risk of breast cancer "in a simpler and more inclusive way. Any woman with dense breasts, personal history, or family history of breast cancer in every first-degree relative is considered to be at increased risk.
She added that breast density is an important risk factor for breast cancer, but it is excluded from all risk models except one.
For each age and risk group of patients, four performance indicators for mammography screening were calculated: cancer detection rate, recurrence rate, and positive biopsy (PPV2) and biopsy (PPV3) predictive value. The withdrawal rate is the percentage of patients who were called up for follow-up testing. PPV reflects the percentage of tumors found between the examinations for which a biopsy was recommended or performed.
In a group younger than 40 years, some women increased their risk due to dense breasts, family history, or a history of breast cancer.
Overall, women aged 30-34 and 35-39 had similar levels of cancer detection, return rates and PPV. In women with at least one of the three risk factors evaluated, the cancer detection rate was significantly higher. In addition, compared to women aged 40-44 with an average risk, the incidence of screening (at least one pre-screening) of women aged 30 years with at least one of the three risk factors evaluated was similar to that of cancer detection and recall rate.
"Women with at least one of these three risk factors may benefit from screening mammography from 30 years instead of 40," Dr. Lee.
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.
Note: Copies of RSNA 2018 messages and electronic images will be available online at RSNA.org/press18 beginning Monday, November 26.
RSNA is an association of more than 54,000 radiologists, radiation oncologists, medical physicists and related scientists who promote excellence in patient care and healthcare through education, research and technological innovation. The company is based in the Czech Republic Oak Brook, Ill. (RSNA.org).
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