Many Breast Cancer Patients in Their 40s Aren’t ‘High-Risk’: Study

THURSDAY, May 3 (HealthDay News) — More than half of women in
their 40s diagnosed with breast cancer after a routine mammogram had no
family history of the disease, finds a new study that may add to the
debate over the timing of breast cancer screening.

The researchers say their results point to the value of annual
screening mammograms for women 40 to 49. But others remain
unconvinced.

Family history usually means a first-degree relative with the disease
(parent, sibling or child). Of those without family history who were found
to have breast cancer, “64 percent of these women had invasive disease,”
said researcher Dr. Stamatia Destounis, a radiologist at Elizabeth Wende
Breast Care Center and a clinical associate professor at the University of
Rochester in New York.

Destounis was to present her findings at the American Roentgen Ray
Society annual meeting in Vancouver on Thursday.

This is one of numerous studies undertaken to determine the ideal age
for women to begin screening mammograms and the appropriate intervals
between screenings. In 2009, the U.S. Preventive Services Task Force
(USPSTF) sparked controversy when it recommended screening mammograms
every two years for women aged 50 to 74, but not younger.

The USPSTF advised women 40 to 49 at average risk of breast cancer to
discuss the pros and cons with their doctors and then decide about the
value of screening. That was because the task force found a small benefit
for the younger women and moderate harm, such as false positive
results.

However, the American Cancer Society and other organizations continue
to recommend annual screening beginning at age 40.

Earlier this week, an analysis published in the Annals of Internal
Medicine
concluded that women in their 40s who have a family history
of breast cancer or extremely dense breasts should consider getting a
mammogram every two years. The researchers said that for those women the
benefits of screening every two years outweigh the risks.

In the new study, Destounis and her colleagues evaluated records of all
mammograms conducted at the imaging center from 2000 to 2010. They focused
on 373 women in their 40s diagnosed with breast cancer after a routine
mammogram. Of these, 228 — or 61 percent — had no family history of the
disease. Seventeen were excluded because of a personal history of cancer
or other high-risk status.

Of the 211 women remaining, nearly 64 percent had invasive disease, and
15 percent had cancer cells in their lymph nodes.

“This study reinforces the importance of screening mammography in the
40-to-49 age group with no family history as a risk factor,” Destounis
concluded.

However, the chair of the USPSTF said the study does not prove that the
cancers were detected because of the mammograms.

“The assumption is made that these women did better because invasive
cancers were found by screening,” said Dr. Virginia Moyer, also a
professor of pediatrics at Baylor College of Medicine in Houston. “The
only way to know that is to randomize [women] to screening or not.” That
would mean assigning one group of women to screening and another to no
screening.

Those are the kinds of studies the task force looked at when producing
the 2009 guidelines, Moyer said. The USPSTF found a small benefit for
women in their 40s balanced by a moderate risk of harms, she said.

“Their data only shows they found invasive cancer, not that the women
benefited directly from the mammogram,” Moyer added.

Data and conclusions of research presented at medical meetings should
be considered preliminary until published in a peer-reviewed medical
journal.

More information

To learn more about mammograms, visit the American Cancer Society.

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