Half of Women Can Benefit from Mammography at Age 40.

A new study shows that women at the age of 40 should undergo a mammogram, as nearly half of them would benefit from the breast cancer screening. For the review, the researchers found that half of the women aged 40 to 44 had above average risk for breast cancer, which made them eligible for yearly screenings.

The findings presented at the American Society of Breast Surgeons annual meeting in Dallas is important because the latest guidelines on mammograms advise that most women can wait until the age of 45 or 50 to start having annual screenings.

But the review of female patients between the ages of 40 and 44 found that 50 percent had an above-average risk for breast cancer, and therefore would be eligible to begin screening mammography at age 40, said lead researcher Dr. Jennifer Plichta. The study also found a significant percentage of women would qualify for other breast screening methods, including breast MRI and genetic testing, Plichta said. “We believe formal risk assessment is essential for women ages 40 to 44 in order to identify those who require screening mammography to start at the age of 40, and those who would qualify for screening MRIs and genetic testing,” Plichta said.

The cancer society updated its guidelines in 2015, recommending that women could wait until age 45 to start receiving annual mammograms. Previously, the cancer society had recommended yearly screenings starting at age 40. The American Society of Breast Surgeons (ASBS) subsequently changed its guidelines to mirror the new cancer society recommendation, Plichta said. The American Society of Breast Surgeons (ASBS) also updated their guidelines with a few more details, which included:

  • Women should have mammograms prior to 45 years of age if their risk of developing breast cancer exceeds 15 percent.
  • Women with 20 percent or higher should also undergo MRI.
  • Women with at least a five-percent risk of a breast cancer-related genetic mutation should undergo genetic testing.

 

“Critical to the development and interpretation of both of these new guidelines is formal risk assessment,” Plichta said. “Furthermore, risk assessment is needed not only to determine who qualifies for mammography, but also who may require screening MRIs and/or genetic testing.”

Breast cancer risk assessments are typically not a part of standard care for this age group, the researchers noted. Since the new guidelines lean heavily on knowing breast cancer risk, doctors need to redouble their efforts to make sure risk assessments are done for women in their early 40s, they concluded.

Bottom line: Given that more than half of women between the ages of 40-45 had risk factors for breast cancer, mammogram screenings should begin at age 40, rather than age 45 or 50. Risk assessment is the best way to determine who would benefit from mammography screening at age 40.

About the author: Raja P. Reddy, MD is a board certified diagnostic radiologist specializing in breast imaging. He is also a contributing editor for Women’s Imaging Specialists, a leading provider of outpatient women’s imaging services in the greater Atlanta, GA area.