The age at which women should start getting screening mammograms is an ongoing debate. While some think there is no downside to earlier routine screening, it can actually lead to a greater chance of overdiagnosis and overtreatment, along with anxiety, inconvenience, and expenses. In 2009, the US Preventive Services Task Force (USPSTF) recommended that women begin breast cancer screening every other year, starting at age 50, rather than at age 40. The USPSTF stated that there was insufficient data to show that starting routine mammography at a younger age would improve patients survival rate.
However, advocates for earlier breast cancer screening are back in the news again. A new study from radiologists at the University of California San Francisco studied the cases of 136 women between ages 40 to 49 who were diagnosed with breast cancer from 1997 to 2012 as a result of mammograms. Half the women had cancer that was invasive, and half had early stage and noninvasive cancer. About 90 percent of the women did not have a strong family history of the disease, and 86 percent did not have dense breast tissue. The researchers concluded from their analysis that physicians could miss as many as 75 percent of breast cancer cases among women in their 40s if the patients did not receive regular mammograms. The research was presented Tuesday at the annual meeting of the Radiological Society of North America.
ACSH s Dr. Gil Ross says, Of course if you start screening earlier using mammography you are going to find more cases of breast cancer. However, that s not the question that needs to be asked. The fact is that many of those cancers detected may never have become life-threatening. As we ve said many times before, while undoubtedly some potentially lethal cancers are found and excised thanks to such screenings, the small number of lives saved from breast cancer deaths are far outweighed by the human and economic toll of overdiagnosis and overtreatment. In simplest terms, hundreds of women have excessive testing, biopsies, lumpectomies, and even mastectomies for lesions found that were not and never would have been life- or health-threatening. It is all but certain that some of these women were actually severely harmed or even killed by unnecessary interventions.