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Less-Frequent Mammogram Testing Benefits Older Women
A mammogram every two years -- instead of every year -- can reduce false positive results for post-menopausal women, according to a new study.
By Erin Hicks
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TUESDAY, Feb. 5, 2013 —Older women may not need to have a mammogram every year, according to researchers from University of California, San Francisco.
In fact, women older than 66 may only need a mammogram every two years, say researchers, who found that for women between 66 and 74, having a mammogram every two years led to significantly fewer false positive results and was just as beneficial in detecting cancer as having an annual mammogram. Their findings were published online today in theJournal of the National Cancer Institute.
To reach their conclusion, the researchers analyzed data that was collected on 140,000 women who received mammogram testing at participating facilities from January 1999 to December 2006. The women were ages 66 to 89 at the beginning of the study.
Forty-eight percent of the women between the ages of 66 and 74 who were screened every year had false positive results, compared with 29 percent of women in the same age range who were screened every two years. There was no difference in rates of late-stage breast cancer between women screened annually and those screened once every two years. "Moreover, the presence of other illnesses such as diabetes or heart disease made no difference in the ratio of benefit to harm," said lead author Dejana Braithwaite, PhD, a UCSF assistant professor of epidemiology and biostatistics, in a press release.
False positives happen when a radiologist looks at a mammogram and sees something on it they cannot definitively say is normal breast tissue. Such a finding usually results in more testing such as an ultrasound, MRI, or biopsy, says Julia Smith, MD., PhD, medical oncologist at New York University's Cancer Institute.
Prior studies have that found younger women have an even higher likelihood of having false positive results on mammograms because their breasts tend to be dense, and mammograms can’t penetrate dense tissue very well, according to Dr. Smith.
“Young, premenopausal women have dense breasts because the whole purpose of the breast as an organ is to make milk in the reproductive years, so there’s more glandular activity before menopause,” says Smith. “After menopause, breasts no longer have the job to make milk, so the glands kind of shrink up, and a higher percentage of the breast tissue becomes fat after menopause.”
Smith says this study raises an important issue, and women have to be educated about how to weigh the possible risk of over-testing and getting a false-positive mammogram result against the risk not having mammograms as frequently and potentially missing an opportunity for early breast cancer detection.
“It’s not clear that we should start screening everyone less,” says Smith. “There are women who don’t need as much screening and would probably benefit from being screened less in terms of fewer [false positives], but there are other women for whom more screening is more appropriate. We can’t give blanket statements, and we have to move towards individualized understanding of the disease and treatment, and screening options for every individual woman,” she says.
Video: Mammography & Breast Cancer Screening Guidelines | Q&A
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