ABSTRACT
MAMMOGRAPHY There is widespread agreement regarding the benefit of mammographic screening every 1-2 years in women aged 50-69 years. Randomized trials have shown a 20-30% reduction in the risk of dying from breast cancer among screened women aged 50-69 years compared with unscreened women1-3. Recommendations for screening women aged 40-49 years are less obvious and less cost-effective, but remain beneficial. Breast cancer incidence is lower in the 40-49 year age group and the younger breast is more radiographically dense, making interpretation more difficult. The American College of Obstetricians and Gynecologists (ACOG) recommends screening women between 40-49 years of age every 1-2 years and
Table 4.1 Recommended mammographic screening intervals Screening should start at age 40 and be performed every 1-2 years and then annually after age 50 Safe age to increase screening interval has not been established Earlier screening is recommended for women with first-degree relatives affected at an early age: • start screening 10 years earlier than the age of diagnosis of the affected relative • women with BRCA 1 and BRCA 2 mutations may want to start annual screening before age 40
annually after age 504. See Table 4.1 for screening guidelines. There is no agreement as to what age to discontinue screening protocols: as breast cancer incidence increases with age, it seems prudent to continue screening as long as the patient’s health permits.
