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September 21, 2013

Breast cancer screening should begin at 40, experts say

New research on the mortality rate of women under the age of 50 who choose not to have mammograms paints a troubling picture, especially considering recent guidelines released by health experts on the frequency and starting age for regular mammograms. Dr. Blake Cady is a professor emeritus at Harvard Medical School and his findings show there are significant benefits for women to start having mammograms early in life.

Some recommendations say age 50

“I would propose that women start screening at age 40,” said Cady. Breast cancers that occur in younger women tend to be more aggressive, thus illustrating the importance of catching the growths early. However, the U.S. Preventive Services Task Force released recommendations in 2009 that say “women aged 50 to 74 should get screening mammograms every two years” and “women under 50 . . . should talk to their doctors and decide whether to be screened based on potential benefits.”

On the other hand, the American Cancer Society recommends that women should start having annual check-ups after age 40 (if their risk is classified as “average”). The sad truth is, 40,000 women die of breast cancer every year.

Most deaths occur in younger women

Cady’s study looked at over 600 breast cancer deaths and each patients’ use of screening and other diagnostic tools. Tragically, “seventy-one percent of the deaths occurred among unscreened women, most of them younger.” The team classified “unscreened” women as those who either had never had a mammogram, or who had not had one in the last two years. Cady went on, “Half of the breast cancer deaths occurred in women under age 50,” while just “13 percent of the women who died of breast cancer were 70 and older.”

Researchers use failure analysis

This method of starting at a patient’s death and tracking backward is called “failure analysis” and is the converse of the normal randomized trial researchers usually work with. Cady’s team used this method so they could “follow people who have died and go backward to their original diagnosis and find out the details.” The earlier the diagnosis, the more likely breast cancer treatments like radiation and surgery will be able to treat the disease with no long term adverse side effects.

The researchers explained that consistent mammograms doesn’t totally get rid of the chance of dying from breast cancer, but “the message here is that mammography is a good part of your prevention plan.”                                         


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