Annual mammography screening beginning at 40 (and continuing through age 79) reduces breast cancer mortality by nearly 42%, according to new data published Tuesday in Radiology.
There’s been much debate in the specialty about when women should begin undergoing these exams, along with how late in life they should continue. Last May, the U.S. Preventive Services Task Force issued draft recommendations calling for every-other-year screening starting at 40 (an adjustment from the previous recommendation for women in their 40s to make an individual decision on whether or not to start screening before age 50). However, imaging advocates have continued to push for annual exams, arguing greater frequency saves more lives.
Now experts have further proof, according to new research. Performing a secondary analysis of 2023 Cancer Intervention and Surveillance Modeling Network (or CISNET) data showed clear benefit from more-frequent checkups.
“The biggest takeaway point of our study is that annual screening beginning at 40 and continuing to at least age 79 gives the highest mortality reduction, the most cancer deaths averted, and the most years of life gained,” lead researcher Debra L. Monticciolo, MD, a professor of radiology at Dartmouth, said in a Feb. 20 announcement from RSNA. “There’s a huge benefit to screening annually until at least 79 and even more benefit if women are screened past 79.”
Monticciolo and colleagues utilized 2023 median estimates of breast cancer screening outcomes from CISNET for their study. The network’s modeling data allowed them to estimate outcomes for differing screening approaches starting at various ages. Estimates demonstrated that yearly mammography screening of women 40 to 79 showed the biggest benefit, cutting mortality by 41.7%. Meanwhile, every-other-year imaging of those 50 to 74 cut cancer deaths by 25.4%, which is compared to 30% for those imaged biennially between 40 to 74. Annual screening from 40 to 79 also showed the lowest per-mammogram false-positive screens (at 6.5%) and benign biopsies (0.9%) versus other screening approaches.
The USPSTF uses Cancer Intervention and Surveillance Modeling Network data to help formulate its recommendations, Monticciolo et al. noted. However, the task force identifies recalls and unnecessary biopsies as patient harm, rather than worthwhile risk to reduce deaths. Women’s chance of having a benign biopsy after annual exams is less than 1%, while recall rates are roughly 10% (and even lower when imaged via tomosynthesis).
“This paper is important because it shows once again that there’s a tremendous increase in mortality benefit by screening annually between the ages of 40-79, and that the chances of experiencing harm are low on a per-exam basis,” Monticciolo said. “It comes down to valuing women’s lives. I am hoping that primary care physicians see that risks of screening are manageable, and the benefits are tremendous. We need to do this for women.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.