In the United States, there are over 30,000 women in their 40’s diagnosed with breast cancer every year.

In this same age group, 5,700 will die from their disease before turning 50 years old. More than 40% of all the years of life lost to breast cancer are from women diagnosed before the age of 50. Breast cancer is the second leading cause of cancer deaths in females ages 35- 54.

There has been so much recent national controversy concerning the mammographic screening of women in their 40’s. What are the facts?

What should I, my family members, and my friends do who are in this age group?

Some have claimed that young women’s breast tissue is too dense to accurately read mammographically, and it is only after the age of 50 that they can be interpreted. This is untrue, since most ladies with dense breasts will always have dense breasts.

Mammography is capable of detecting 90% of breast cancers...

and studies have shown that the majority of breast cancers found by mammography are smaller, and of an earlier clinical stage than those discovered by clinical breast exam. This holds true for women both under and over the age of 50.

Critics have stated that mammography does not improve the survival rates of women diagnosed with breast cancer between the ages of 40- 49. This has been proven false by two very large studies, one based in the US called the BCEDP project, and the other, a Swedish study called the Two County Kopparberg trial. Both of these have shown that there is no significant difference in survival among younger verses older women, when tumors were matched for size, stage, and type.

The value of mammography in the 40- 49 year age group is even more essential in light of recent findings that these cancers seem to grow faster and more aggressively than in older women. In general, mammography can find a tumor two years before it can be felt in this age period. It therefore makes sense that mammographic screening would have to be performed much earlier than every two years to be of benefit, and to give the woman the advantage of early detection.

What about the risk of radiation from the mammogram itself to women who start yearly screening beginning in their 40’s?

There has never been any evidence that breast cancer has been caused by mammography. In terms of theoretical risk, it has been proposed that the ratio of years of life saved, over the years of life lost because of radiation induced breast cancer in women in their 40’s, would be 121(years saved)/1(year lost). Which odds do you prefer?

The final link in the chain of controversy is economics. Annual mammography for women in their 40’s would double the cost of breast cancer screening in the US. However, it would decrease cancer deaths by 25- 40%. Also, mammographic screening costs less than other preventive measures per year of life expectancy gained, such as: seat belts; air bags; and even pap smears for cervical cancer. In 1996, the number of invasive breast cancers diagnosed in women in their 40’s, was twice the total number of cases of cervical cancer in females of all ages!

Now that you’ve read the arguments against, and the rebuttals for mammographic screening of women in their 40’s, you decide what you’ll do and how you’ll advise those you care about.

Remember, mammography has been proven a lifesaving tool, decreasing breast cancer deaths in asymptomatic women of all ages, not just those over the age of 50.

Click here to view an interview about the Breast Health Center and why you need to get a mammogram!

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