Mammography Starting at Age 40 Saves Lives

An article in the February issue of the American Journal of Roentgenology provides further support for the benefits of screening mammography starting at age 40. The authors, Dr. Ed Hendricks and Dr. Mark Helvie, analyzed the evidence considered by the United States Preventative Services Task Force (USPSTF) – whose November 16, 2009 guidelines recommended against screening mammography starting at age 40 based on harms outweighing benefits.

Some highlights from this article:

• Benefit of screening: 39.6 percent mortality reduction from annual screening of women 40-84 years old vs. 23.2 percent mortality reduction if following USPSTF task force recommended biennial screening between ages 50-74.
• Potential harms (women 40-49):  risk of recall every 12 years, negative biopsy every 149 years, missed cancer every 1000 years, fatal radiation-induced breast cancer every 76,000-97,000 years.

If all U.S. women currently aged 30-39 undergo annual screening mammography between ages 40-84, an estimated 100,000 more lives will be saved than if following the current USPSTF guidelines of biennial (every 2 year) screening between ages 50-74. If only 65 percent of these women undergo screening (current compliance rate), then approximately 65,000 more lives would be saved under annual screening between ages 40-84.

The Women’s Imaging Section at UCSF continues to support the American Cancer Society guidelines of annual mammography screening starting at age 40. Women at high risk may need to start screening earlier and women at very high risk may benefit from the addition of breast MRI.