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Geographic distribution of facilities in the National Mammography Database (NMD). NMD is the largest database of mammograms in the United States. It has 1,087 registered facilities, 370 active facilities and 584 newly registered facilities. In April 2018, the NMD had 21,484,196 million mammograms, of which more than 5 million last year. Credit: Radiology Society of North America
A new large-scale study of more than 5 million mammograms has shown that annual mammography screening at age 30 can benefit women with at least one of the following three risk factors: dense bads, antecedents personal bad cancer or family history of bad cancer. Cancer. The study will be presented today at the annual meeting of the North American Radiology Society (RSNA).
Mammography is the standard imaging examination for bad cancer screening. The American Cancer Society states that women should have the option of having an annual mammogram from age 40 and recommends that all women at average risk be screened annually starting at age 45. Some other major occupational groups recommend annual mammography screening beginning at age 40. and RSNA supports this recommendation.
However, for younger women, the guidelines are less clear.
"Women under 40 are not at the center of our bad cancer screening concerns," said Cindy S. Lee, MD, badistant professor of radiology at NYU Langone Health in New York. "Everyone is talking about 40 to 49, not 30 to 39. It is difficult to study this group because most women in this age group do not undergo mammography, but some these young women have an increased risk of bad cancer and may require early and / or complementary screening. "
For the study, Dr. Lee and colleagues compared the performance metrics of screening mammography in women aged 30 to 39 years with three specific risk factors compared to women aged 40 to 49 years, without these risk factors, using data from the national mammography database. (NMD), the largest source of mammography screening results in the United States. NMD contains information from more than 19 million mammograms, including patient demographics, clinical outcomes, mammography interpretations, and biopsy results.
Researchers badyzed data from more than 5.7 million screening mammograms performed on more than 2.6 million women over eight years between January 2008 and December 2015 at 150 facilities in 31 US states. The research team compared screening performance measures among subgroups of women. on age, risk factors and bad density.
In this study, three specific risk factors for bad cancer were badessed: family history of bad cancer (any first-degree relative regardless of age), personal history of bad cancer and bad dense.
"Current models of bad risk prediction incorporate different risk factors, which are weighed differently and can produce different results for the same patient.This complexity can create confusion and uncertainty for physicians and patients "said Dr. Lee. "Our study has defined the 'increased risk of bad cancer' in a simpler and more inclusive way." Any woman with dense bads, a personal history or a family history of bad cancer at home. every first degree relative is considered to be at increased risk. "
She added that bad density is an important risk factor for bad cancer, but that it is excluded from all risk models except one.
Four performance measures for screening mammography were calculated for each age and risk group of the patient: cancer detection rate, recall rate, and positive predictive value for the recommended biopsy (PPV2) and performed biopsy (PPV3). The recall rate is the percentage of patients referred for follow-up testing after a screening test. The PPV reflects the percentage of cancers detected among the examinations for which a biopsy was recommended or performed.
Among women under 40, some women were at increased risk because of bad density, family history, or personal history of bad cancer.
Overall, women aged 30 to 34 and 35 to 39 had cancer detection rates, recall rates and similar PPVs. Cancer detection rates were significantly higher among women with at least one of the three risk factors badessed. In addition, compared to women aged 40 to 44 at average risk, screening for the incidence (at least a previous screening test) of women in their thirties with at least one of three risk factors evaluated showed cancer detection rates and similar recall rates.
"Women with at least one of these three risk factors could benefit from screening mammograms starting at age 30, instead of age 40," said Dr. Lee.
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