Fertility treatment may be an opportune time to also screen women in their 40s for breast cancer, radiologists charged in a new study published Thursday.
Medical societies have offered varying guidance on when to initiate regular mammography visits, with some recommending age 40 while others advocate waiting longer. Birth rates are on the rise among this age segment as more women put off childbearing until later in life. Why not use the time prior to administering assisted reproductive technology to screen for the disease?
University California, San Francisco, physicians sought to answer this question, marrying mammography and ART as part of a retrospective study. The practice change appears promising, researchers concluded in Clinical Imaging.
“Our study suggests that women between ages 40 to 49 should undergo screening mammography prior to [assisted reproductive technology] as it may identify clinically occult breast malignancies,” radiologist and professor Heather Greenwood, MD, and colleagues wrote Sept. 2. “Future studies of this unique patient population with larger numbers would help confirm these recommendations,” they added later.
For their analysis, UCSF researchers reviewed electronic health records seeking those in their 40s who received a mammogram prior to fertility treatment between 2010-2018. A total of 118 women met the criteria at an average age of 42. Providers recalled 14% (6/118) for further diagnostic workup, and 31% (5/16) needed a biopsy. In the end, 1 of those 5 tests resulted in a malignancy, for a cancer detection rate of 8.5 women per 1,000 screened (0.85%). The single case occurred in an asymptomatic 40-year-old woman who had a family history of premenopausal breast cancer in two cousins.
“Our data are helpful for women 40-49 planning fertility treatment, especially given the current state of conflicting recommendations by different societies regarding when to start and how often to perform screening mammography for women 40 to 50 years of age,” Greenwood et al. advised. “Our results show that screening women in this age group prior to ART may identify asymptomatic breast malignancies, which could potentially be rapidly worsened by the elevated hormonal states of fertility treatment and/or pregnancy if left unidentified.”
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.