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Experts do not know if some women should start screening sooner.
A new study suggests that mammograms from the age of 30 may be suitable for women with certain risk factors, but experts say the screening method may not be effective for this group.
The study presented today at the annual meeting of the North American Radiology Society revealed that an annual mammogram beginning at age 30 could benefit women with dense breasts. or a family history or personal history of breast cancer.
Researchers analyzed data from more than 5 million mammograms performed on more than 2.6 million women between 2008 and 2015 in 150 facilities in 31 states of the United States.
Mammography is the standard approach used to screen for breast cancer. The American Cancer Society recommends that women at average risk of breast cancer undergo an annual mammogram from age 45, and then every two years from age 55.
The company also suggests that women could choose to have a mammogram at age 40.
Other organizations, including the North American Radiology Society, recommend annual mammograms at age 40, but recommendations for younger women are not as clear.
"There is not enough published data on this topic, but most organizations recognize that women at risk of breast cancer need earlier or additional screening.
"Our findings suggest that mammography screening recommendations should be personalized based on the woman's age, breast density, personal history of breast cancer, and family history of breast cancer," she said. Dr. Cindy Lee, author of the study and assistant professor. Radiology at NYU Langone Medical Center, told Healthline.
Lee points out that in 2018, the American College of Radiology began recommending that all women be evaluated for breast cancer risk at the age of 30 years.
"Our findings raise the question of whether this baseline risk assessment should include a 30-year screening mammogram to determine breast density practices that routinely recommend screening 40-year-old women," she said. . "Future research is needed to evaluate the risks and benefits of performing a basic mammogram at the age of 30 years."
Although much research has been done on the 40 to 49 age group, Lee says it has been difficult to study women aged 30 to 39 because most women in this age group age do not undergo mammography. But that does not mean they are not at risk of breast cancer.
More than 1,000 women under 40 die each year from breast cancer in the United States.
"Most women diagnosed with breast cancer are 40 years old or older. However, according to the latest statistics from the American Cancer Society, 4% of breast cancers will be diagnosed in women under 40 years of age. With over 250,000 new breast cancer diagnoses each year, it's not a negligible number of women, "Dr. Lauren Nye, an oncologist at the University of Kansas Cancer Center, told Healthline.
In this latest study, Lee and colleagues evaluated three specific risk factors: a family history (considered a first-degree relative diagnosed with breast cancer, regardless of age), a personal history of breast cancer, or dense breasts.
"Dense breasts can mask underlying mammographic abnormalities, including breast cancers. Having more fibroglandular breast tissue (and less fat) is also associated with an increased risk of breast cancer, "Lee told Healthline.
But experts not associated with the study have advised caution during mammographic examination at age 30, especially on the basis of dense breasts.
Dense breasts are common in younger women. Research estimates that 74% of women aged 40 to 49 have dense breasts, compared to only 36% of women aged 70. Most women under 40 have dense breast tissue.
Breast density in mammography refers to the amount of parenchymal tissue relative to the amount of adipose tissue in a breast. Parenchymal tissue appears white on mammography – as are cancerous masses. Cancers can be harder to detect in people with dense breasts.
Diana Miglioretti, PhD, professor of biostatistics at UC Davis School of Medicine, explains that, since most women in their thirties have dense breast tissue, the benefits of mammography for women with no personal history of breast cancer breast can not compensate for the risks.
"Women with dense breasts are more likely to experience false alarms and benign biopsies following a screening mammogram. Screening for women in their thirties with dense breasts will likely result in many false alerts and benign biopsies without much benefit, because of the very low rate of cancer in this age group, "she said. at Healthline.
Miglioretti points out that, according to current guidelines, "all women with a history of breast cancer should be screened annually (unless there is a double mastectomy), regardless of age".
"In addition, women with a risk factor that puts them at very high risk, such as women with a genetic mutation or anterior chest radiotherapy for cancer treatment, should start screening at a younger age," she says. she said.
"For other women, even those with a family history or dense breasts, the benefits of screening mammography in the 1930s will likely outweigh the disadvantages of screening in this age group." because breast cancer is so rare in this age group, "Miglioretti added. .
Dr. Onalisa Winblad, a radiologist at the University of Kansas Cancer Center, says other forms of assessment may be useful for women under 40 years of age.
"At the age of 30, a woman should meet with her doctor and discuss the risk of breast cancer to determine whether early or complementary breast cancer screening could be indicated. The clinical breast examination by a qualified health professional can also start at age 20, she said.
At present, no country or organization has guidelines recommending mammography for women under 40, except in the case of personal history of breast cancer or other risk factors that would expose them to a very high risk.
"Mammography simply does not work well in younger women, mainly because of the density of breast tissue," said Dr. Deanna Attai, Clinical Assistant Professor at UCLA's David Geffen School of Medicine at Healthline. "In women with a family history of breast cancer, we often start screening 10 years before the diagnosis of the youngest parent, but in younger women, do not rely solely on mammography."
Attai said that for patients at increased risk due to genetics or the BRCA gene, they would start screening earlier and would often use other tests, such as MRI or ultrasound devices, in addition to mammography.
She recommends that women who are concerned about their breast cancer risk speak with their doctor and regularly conduct their own breast exams.
"It is prudent for women to practice self-awareness within the breast. Understand the sensations of your normal breast tissue and monthly changes, periodically check and report any changes to your doctor, "said Attai.
"In addition, know the risk factors and your family history of breast cancer and other cancers, and discuss it with your doctor. High-risk women may be recommended for mammography or other screening tests such as ultrasound or MRI, she said.
A recent study suggests that a mammogram beginning at age 30 could be beneficial for women with a personal history of breast cancer, family history or dense breasts.
But experts say mammography may not be effective for women in this age group and other assessments would be more beneficial. Women concerned about their risk of breast cancer should consult their doctor.
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