Family pedigree may hold answers to breast cancer mammogram recommendations

Last December, the U.S. Preventative Task Force, an independent panel of health experts, raised some controversy when it upped the age at which women should receive yearly mammograms from 40 to 50. Now, a new study published in the Lancet Oncology is asking whether women younger than 50 who have an intermediate familial risk of breast cancer (they have several relatives with breast cancer or their relatives were diagnosed with the disease at a young age) should get a yearly mammogram in order to save more lives. The Family History 01 study recruited 6,710 U.K. women at a medium familial risk of breast cancer and gave them an annual mammography for an average of four years. For the comparison group, researchers obtained data for women who did not receive a mammogram from two independent trials — the U.K. Age Trial and a Dutch study of women with a family history of breast cancer. The results indicated that women who received the screenings had tumors that were significantly smaller, of a more favorable grade and less likely to be node positive. These women were also significantly more likely to be alive 10 years after a diagnosis of invasive cancer.

“There has been a tremendous amount of controversy over when to begin mammograms, so this study could potentially resolve some of this conflict for women who have a family history of breast cancer,” observes ACSH’s Dr. Elizabeth Whelan.

The study has some drawbacks however, including using control groups that were taken from prior surveys. “This is not the preferred way to conduct a controlled study; there were enough women in the study — 6,710 — such that a control group of women not given more frequent mammograms could have been randomized, thereby increasing the study’s validity,” explains ACSH's Dr. Gilbert Ross.

In addition, ACSH’s Dr. Josh Bloom notices that the study gives absolutely no information concerning the average age of the recruited participants, which is “kind of odd.” He adds, “It seems these researchers are giving more mammograms to women of an indeterminate age. At best, their conclusions are merely a suggestion that early mammography is helpful for high-risk women, but we can’t tell exactly how helpful it really is, since there is a surprising lack of information about something that seems to be very important.”