Study examines outcomes of screening mammography for age, breast density, hormone therapy

March 18, 2013

A study that compared the benefits and harms of the frequency of screening mammography to age, breast density and postmenopausal use of hormone therapy (HT) suggests that woman ages 50 to 74 years who undergo biennial screenings have a similar risk of advanced-stage disease and a lower cumulative risk of false-positive results than those who get mammograms annually, according to a report published Online First by JAMA Internal Medicine.

In 2009, the U.S. Preventive Services Task Force issues guidelines that biennial mammography, rather than the previously recommended mammography every one to two years, be performed for women ages 50 to 74, but the updated guidelines did not consider the influence of factors beyond age, according to the study background.

Karla Kerlikowske, M.D., of the University of California, San Francisco, and colleagues sought to determine whether the benefits, such as early detection, and the harms, such as a false-positive mammography result or biopsy recommendation, differ among women undergoing according to age, breast density and postmenopausal HT use.

Researchers analyzed data collected from January 1994 to December 2008 from mammography facilities in community practice that participate in the Surveillance Consortium (BCSC) mammography registries. Data were collected from 11,474 women with breast cancer and 922,624 without breast cancer.

The authors found that biennial vs. annual mammography for women ages 50 to 74 was not associated with an increased risk of advanced-stage or large-size tumors regardless of a women's breast density or HT use. However, the results indicate that among women ages 40 to 49 years with extremely , biennial mammography vs. annual was associated with an increased risk of advanced-stage cancer (odds ratio [OR], 1.89) and large tumors (OR, 2.39).

Study results also show that the cumulative probability of a false-positive mammography result was high among women undergoing annual mammography with extremely dense breasts who were either ages 40 to 49 years (65.5 percent) or used estrogen plus progestogen (65.8 percent) and was lower among 50 to 74 years who underwent biennial or triennial mammography with scattered fibroglandular densities or fatty breasts.

"In conclusion, women aged 50 to 74 years, regardless of or HT use, can undergo biennial rather than annual mammography because biennial screening does not increase the risk of presenting with advanced disease but does substantially reduce the cumulative risk of a false-positive mammography result and biopsy recommendation. Women aged 40 to 49 years with extremely dense breasts who choose to undergo mammography should consider annual screening to decrease the risk of advanced-stage disease but should be informed that annual screening leads to a high cumulative probability of a false-positive mammography result because of the additional screening examinations," the study concludes.

Explore further: High rate of false-positives with annual mammogram

More information: JAMA Intern Med. Published online March 18, 2013. doi:10.1001/jamainternmed.2013.307

Related Stories

High rate of false-positives with annual mammogram

October 17, 2011
During a decade of receiving mammograms, more than half of cancer-free women will be among those summoned back for more testing because of false-positive results, and about one in 12 will be referred for a biopsy.

ACR, SBI support updated ACOG recommendations that women begin annual mammograms at age 40

July 20, 2011
The American College of Radiology (ACR) and Society of Breast Imaging applaud and support updated American College of Obstetricians and Gynecologists' (ACOG) recommendations that women begin getting annual mammograms at age ...

Annual mammography with screening ultrasound may benefit women at increased risk of breast cancer

April 3, 2012
The addition of a screening ultrasound or magnetic resonance imaging (MRI) to annual mammography in women with an increased risk of breast cancer and dense breast tissue resulted in a higher rate of detection of incident ...

Researcher calls for mammograms to be tailored to patient

September 30, 2011
Mammograms are not one-size-fits-all, says noted breast cancer researcher Karla Kerlikowske, MD, of the University of California, San Francisco (UCSF). Rather, they should be customized based on a woman’s age, breast ...

Recommended for you

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.