Younger Women with Family History of Breast Cancer Should Start Mammograms Before Age 40 (dateline April 27, 2000)
A new study by researchers from The Netherlands confirms
previous studies that show younger women who have a family history
of breast cancer benefit from starting annual
mammograms before age 40. According to the new
study, women who have a family history of breast cancer are at a higher lifetime risk of
developing the disease than other women and should follow stricter guidelines to help
detect breast cancer early, when the treatment is often less invasive and the chances for
survival are much higher.
Based on the results of the study, the researchers recommend that women with a 25% higher lifetime risk for breast cancer:
- practice monthly breast self-exams
- have physician performed clinical breast exams twice a year
- begin screening mammograms at age 25.
Women with two first-degree relatives (sister, mother) who developed breast cancer by age 50 were at a 25% higher risk for breast cancer , according to the researchers. Women who had one first-degree relative with breast cancer were said to be at moderate risk for the disease.
In the study, researchers compared two groups of moderate-risk women over a period of three and a half years. The purpose was to determine whether younger women with a family history of breast cancer would benefit from receiving screening mammograms, even though they did not show any signs or symptoms of breast cancer (such as a lump, thickening, or skin dimpling).
The first group in the study was called the "surveillance group" because they did not show any signs or symptoms of breast cancer. These women received yearly clinical breast exams and yearly screening mammograms. A "screening" mammogram is a basic two-view mammogram performed in patients with no symptoms of breast cancer. Those who had more than one relative with breast cancer received mammograms every six months.
The "surveillance group" was compared to a group of women who were experiencing signs that could indicate breast cancer (such as a lump, skin or nipple abnormalities, or inflammatory breast disease). This second group was called the "symptomatic group." The women in the "symptomatic group" only received mammograms if they showed signs that could indicate breast cancer.
Study Summary: Young Women at Moderate Risk for Breast Cancer
|"Surveillance Group" (received annual mammograms)||"Symptomatic Group" (only received mammograms if breast cancer symptoms were present)|
After three and a half years, the researchers found 26 breast cancers in the "surveillance group." Of these cancers, 81% were found to be in an early stage and the chances of survival were very good. However, among the "symptomatic group," only 46% of cancers found were in an early stage. Also, only 19% of the breast cancers had spread to the axillary (underarm) lymph nodes in the "surveillance group" compared with 42% in the "symptomatic group."
The results of the study show that younger women are more likely to be diagnosed with an early stage breast cancer if they begin yearly screening mammograms before age 40, even if they do not show any signs or symptoms of breast cancer.
Currently, the American Cancer Society recommends:
- All women between 20 and 39 practice monthly breast self-exams and have a physician performed clinical breast exam at least every three years.
- All women age 40 and older have annual screening mammograms, practice monthly breast self-exams, and have yearly clinical breast exams.
Click here for more details about these guidelines.
Women with a family history of breast cancer or those who test positive for the BRCA1 (breast cancer gene 1) or BRCA2 (breast cancer gene 2) mutations may want to talk to their physician about beginning annual screening mammograms earlier than age 40, as early as age 25 in some cases.
- The study discussed in this article appears in the March 2000 issue of European Journal of Cancer.
- The April 17, 2000 Reuters Health report, "Early Mammograms Benefit Women at High Risk," is available at http://dailynews.yahoo.com/h/nm/20000417/hl/wmb_9.asp
- To learn more about mammography, please visit http://www.imaginis.com/breasthealth/mammography.asp