Annual Breast Cancer Screening from Age 40-79 Offers Highest Mortality Reduction

In In The News by Barbara Jacoby


In a breakthrough study published in the Radiological Society of North America (RSNA), researchers have shed new light on breast cancer screening practices. The study, led by Dr. Debra L. Monticciolo, has revealed compelling evidence in favor of annual breast cancer screening beginning at age 40 and continuing through at least age 79.

Breast cancer remains a significant health concern for women in the United States. Ranking as the second most common cause of cancer death. Despite the well-documented effectiveness of regular screening mammography in reducing breast cancer mortality by 40%. A staggering percentage of eligible women—only 50% or less—actually participate in annual screening.

Debates Over Screening Recommendations

Dr. Monticciolo noted the ongoing debate surrounding breast cancer screening recommendations, particularly regarding the age at which to commence screening and its frequency. The 2009 recommendation by the U.S. Preventive Services Task Force (USPSTF) advocating for biennial screening starting at age 50 resulted in a decline in screening participation nationwide. However, the USPSTF revised its stance in 2023, suggesting biennial screening between ages 40 and 74. In contrast, organizations such as the American College of Radiology, the Society of Breast Imaging, and the National Comprehensive Cancer Network endorse annual screening for women at average risk beginning at age 40.

Study Methodology and Analysis

The study conducted by Dr. Monticciolo and her team involved a secondary analysis of Cancer Intervention and Surveillance Modeling Network (CISNET) 2023 median estimates of breast cancer screening outcomes. CISNET modeling provided the opportunity to estimate screening outcomes at various frequencies and starting ages using U.S. data.

Comparing four different screening scenarios—biennial screening of women aged 50-74, biennial screening of women aged 40-74, annual screening of women aged 40-74, and annual screening of women aged 40-79. The researchers found that annual screening of women aged 40-79 resulted in the highest mortality reduction at 41.7%. Additionally, this approach showed the lowest per mammogram false-positive screens (6.5%) and benign biopsies (0.88%) compared to other scenarios.

Implications and Recommendations

Dr. Monticciolo emphasized the importance of their findings, stating that annual screening from age 40 to 79 provides the highest mortality reduction, most cancer deaths averted, and most years of life gained. She highlighted the manageable nature of screening risks compared to the potential lethality of advanced breast cancer.

The USPSTF’s concerns include recall rates and benign biopsies as potential harms. Dr. Monticciolo underscored the manageable nature of these risks compared to the benefits of early cancer detection. She urged primary care physicians to recognize the tremendous benefits of annual screening for women aged 40. Additionally, emphasized the need to prioritize women’s lives by adopting early detection strategies.

The study adds to the growing body of evidence supporting annual screening from age 40. Breast cancer being easier to treat when detected early. The findings underscore the importance of regular screening in saving lives and reducing the burden of advanced-stage disease.

Dr. Monticciolo expressed hope that the study’s findings would encourage policymakers to prioritize annual screening from age 40. Thus ensuring that more women have access to life-saving early detection measures.

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