Can Earlier Mammographic Screenings Affect Mortality Rates?

When should women begin getting mammograms? Guidance can vary based on an individual’s family history or other high-risk identifiers, but physicians advise that women get screened for breast cancer consistently by at least age 50. However, a recent study out of the United Kingdom suggests that starting breast cancer screenings earlier could have a large impact on the mortality rate of the disease.

As research continues to focus on technologic advancements to improve the efficiency and effectiveness of mammographic screenings, is it possible that being able to receive earlier screenings could also play a role in improving breast cancer mortality?

Screenings Starting at 40

A study in The Lancet Oncology detailed a UK Age trial that began yearly breast cancer screenings in women from around the age of 40 years and older.¹ This differs from the UK’s breast cancer screening program that advises mammograms every 3 years for women aged 50 to 70. Across 23 breast screening units in England, Wales, and Scotland, 160,921 women aged 39 to 41 were recruited for the study between 1990 and 1997. One-third of the participants (53,883) were randomly assigned to the intervention group, which  involved receiving yearly mammographic screenings up to and including the age of 48. The other two-thirds of women (106,953) were assigned to standard screening beginning at age 50.

Following up on these women after 10 years, the investigators found that 83 women in the intervention group had died of breast cancer compared with 219 women in the control group. The researchers saw this as a significant reduction in breast cancer mortality, while the reduction in mortality was seen as less significant after 10-year follow-up (126 deaths attributed to breast cancer in the intervention group vs 255 in the control group).

The researchers concluded that earlier and more frequent mammographic screenings (yearly screenings beginning around age 40 to 41 as opposed to every 3 years beginning at age 50) was associated with a reduction in breast cancer mortality. They suggested that 11.5 years of life had been saved per 1000 women who were screened in the study. As a result, their takeaway was to recommend reducing the lower age limit of mammograms from 50 years to 40 years.

This study is not the only recommendation for a lower age for breast screenings. The American Cancer Society recommends that women should get mammograms every year from the ages of 45 to 54, and that they should be allowed the choice to begin these screenings from ages 40 to 44.² This, in their estimation, is more effective for early detection of breast cancer.

References

1. Duffy S, Vulkan D, Cuckle H, et al. Effect of mammographic screening from age 40 years on breast cancer mortality (UK Age trial): final results of a randomised, controlled trial. The Lancet Oncology. 2020;21(9):1165-1172. doi:10.1016/s1470-2045(20)30398-3
2. American Cancer Society Guidelines for the Early Detection of Cancer. Cancer.org. https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html.  Revised July 30, 2020. Accessed September 10, 2020.

This article originally appeared on Cancer Therapy Advisor