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mammographyA recent study conducted by physicians from Harvard University has published a conclusion that has not been previously suggested. The study states that,” Most deaths from breast cancer occur in unscreened women. To maximize mortality reduction and life-years gained, initiation of regular screening before age 50 years should be encouraged.”[1]

The study examined the records of 7301 patients between 1990 and 1999. What the researchers found was that among 609 confirmed breast cancer deaths, 29% were among women who had been screened, whereas 71% were among unscreened women. The other discovery was that this group included those women who had taken more than 2 years since their last mammogram (6%) and those who were never screened which was 65% of the women who died from breast cancer. [2] Of all breast cancer deaths, only 13 percent occurred in women aged 70 or older, but 50 percent occurred in women under age 50. Among women diagnosed with breast cancer, those who died of the disease were a median of 49 years old at diagnosis; for those dying of any other cause, the median age at diagnosis was 72 years. The past belief was that screening s led to over diagnosis, but this study clearly shows that this is not the case.

  The findings supported the conclusion that most women who are dying from breast cancer are not getting mammograms. A second issue was that women need to get screened before the age of 50. The United States Preventative Services Task Force recommended in 2009 that routine breast cancer screening with mammograms only be given to women between the ages of 50 and 74. The Centers for Disease Control (CDC) recommends that women age 50 to 74 years should have a screening mammogram every two years.  They follow that women age 40–49 years, should talk to their doctor about when and how often you should have a screening mammogram.

 The American Cancer society recommends that women need to be screened by mammography starting at age 40 for breast cancer and that clinical breast exams should begin in women as young as 20. The American College of Obstetricians and Gynecologists recommends that based on the incidence of breast cancer, the sojourn time for breast cancer growth, and the potential reduction in breast cancer mortality, that women aged 40 years and older be offered screening mammography annually.[3]

A study published in 2011 published in Radiology also showed that women between 40 and 74 who were invited to routine mammogram screenings every 24 to 33 months had a 30 percent lower breast cancer death rate compared to those following routine recommendations.  The study that was conducted shows a much firmer conclusion for the recommendations of the American Cancer Society and American College of Obstetricians and Gynecologists. Women receive a greater benefit from starting mammograms early in their 40’s rather than later.

[1] Webb, M. L., Cady, B., Michaelson, J. S., Bush, D. M., Calvillo, K. Z., Kopans, D. B. and Smith, B. L. (2013), A failure analysis of invasive breast cancer. Cancer. doi: 10.1002/cncr.28199

[2] Ibid

[3] American College of Obstetricians and Gynecologists (COGNAC), Breast Cancer Screening. National Guidelines Clearinghouse, Agency for Healthcare Research and Quality.