Large Study Recommends Mammograms Beginning at Age 40

Recent trends in breast cancer detection have wavered. To perform breast self-exams or not? To get mammograms or not?

The worry about breast self-exams is that they might skew results into too many false-positive tests. Some who recommend fewer mammograms have suggested that over-screening leads to unnecessary invasive tests and undue anxiety.

However, the 2011 Breast Cancer Symposium of the American Society of Clinical Oncology (ASCO) overwhelmingly supports these preventive measures, and the American Cancer Society agrees.

“While there has been ongoing debate about when and how breast cancer screening should occur,” Dr. Jamie Caughran, medical director of the Comprehensive Breast Center at the Lacks Cancer Center in Grand Rapids, MI, said, "this study validates that women who undergo regular mammography screening present at earlier stages and often require less aggressive treatment than those who do not.”

Caughran, who helped to lead a research team for a recent study on mammography, said that women aged 40 and and older should use both self-exams and mammographies as means of detection. High-risk patients should seek advice from their doctors about the age for and frequency of tests.

The study, completed this year with data from nearly 6,000 women with breast cancer, counters guidelines by the U.S. Preventative Services Task Force (USPSTF), which recommends that women get mammograms every two years beginning at age 50. The USPSTF does note, though, that screenings should be determined on an individual basis.

Among other findings in the Michigan study:

• Breast cancer in women younger than 50 was more likely to be detected first by feel than by mammography. Of the women whose tumors were found by feel, 40 percent were younger than 50.
• Overall, 65 percent of the breast cancer cases were detected by mammography, while 30 percent were detected by feel and the other 5 percent by other methods.
• For women diagnosed with breast cancer before age 50, 49 percent of the cases were detected by mammogram. Of those, 18 percent were Stage 2, and 4 percent were Stage 3.
• For women diagnosed with breast cancer before age 50, 46 percent of the cases were detected by feel. Of those, 50 percent were Stage 2, and 17 percent were Stage 3.
• For women older than 50, 81 percent of breast cancers are detected through mammography.

In 2011, the ASCO predicts 230,480 new cases of breast cancer for women; 2,140 for men; and 57,650 non-invasive cases. About one in eight women will develop breast cancer, according to the ASCO.

“Women of all ages are presented with palpable tumors, highlighting the use of self-breast exam as an important public health measure,” Caughran said.