Mammography Screening Should Vary from Woman to Woman
A new national study concludes that women should not have mammograms on the same schedule. Led by co-senior author Anna N. Tosteson, ScD, co-Director of the Cancer Control Research Program at Norris Cotton Cancer Center, this large computer modeling study found that the majority of women ages 50 to 74 at average risk and lower breast density can retain most of the benefit of having mammograms less often—every 3 years—while reducing downfalls such as false positive results, unneeded biopsies, overdiagnosis and screening costs with minimal effect on breast-cancer deaths averted. Women with dense breasts, however, have a higher risk of breast cancer and should be screened every year, as detection is more difficult in dense breast tissue. Other risk factors include family history of breast cancer, previous breast biopsies and other considerations. “Our study informs women and their health care providers about how cancer screening may be tailored for individual women based on each woman’s risk and breast density,” Tosteson explains. “I hope the information we provide will foster informed decisions about breast cancer screening.”
The study, “Tailoring Breast Cancer Screening Intervals by Breast Density and Risk for Women Aged 50 Years or Older: Collaborative Modeling of Screening Outcomes,” was recently published in the Annals of Internal Medicine.
Tosteson and researchers from the Breast Cancer Surveillance Consortium (BCSC) and the Cancer Intervention and Surveillance Modeling Network (CISNET) used three well-established models to evaluate outcomes using various screening intervals for digital mammography among subgroups of women based on age, risk, and breast density. “Breast cancer screening should not be a ‘one-size-fits-all’ undertaking,” concludes Tosteson. “The balance of benefits and harms depends on each woman’s breast cancer risk and density. How these benefits and harms are weighed will depend on individual women’s preferences.”
Future studies will look at screening intervals for younger women according to their density and risk level. This study was funded by the National Cancer Institute.