Half of Women Qualify for Breast Screening at Age 40 Under New Guidelines

A new study found that half of women age 40 to 44 evaluated at an academic practice qualified for annual mammography screening, even with new guidelines that recommend that women with an average risk of developing breast cancer start screening at age 45. Results of the study were presented at the 2016 American Society of Breast Surgeons Annual Meeting, held April 13–17 in Dallas, Texas.

In October of last year, the American Cancer Society (ACS) released an updated guideline on screening mammography. While prior guidelines recommended that women receive an annual mammogram starting at age 40, the new update stated that women between 40 and 44 with average breast cancer risk may no longer require an annual mammography. Those with an above-average risk are still recommended to receive a mammogram every year starting at age 40.

The American Society of Breast Surgeons (ASBrS) released similar guidelines but stated that an annual screening mammogram should be conducted for women starting at age 40 who have a lifetime risk of 15% or greater. Those women with a risk of 20% or greater are recommended to undergo annual mammography screening along with MRI and genetic testing.        

Jennifer Kay Plichta, MD, of the Loyola University Medical Center in Maywood, Illinois, and colleagues analyzed a single institute database of 6,964 women, 909 of whom were between the ages of 40 and 44 and did not have a breast cancer diagnosis. Patient-reported risk factors and family history were included. According to the researchers’ risk evaluation, 352 women (39%) were found to have an above-average risk of breast cancer by the ACS criteria. An additional 103 women (11%) were eligible to start screening at age 40 using the ASBrS guideline. Combined, a total of 50% of the women were eligible for screening mammography at age 40.

“We believe that formal risk assessment is essential for women between ages 40 and 44 in order to identify those who require screening mammography to start at age 40 and those who qualify for screening MRI and genetic testing,” said Plichta at a presscast presentation of the study.

Fifty-nine women (6.5%) were at risk for harboring a germline breast cancer–related genetic mutation and 127 (13.8%) qualified for MRI screening. Another 166 women (18.3%) qualified for both genetic testing and MRI.

“Our study was large and comprehensive,” said Kevin S. Hughes, MD, FACS, co-director of the Comprehensive Breast Evaluation Center at Massachusetts General Hospital and associate professor of surgery at Harvard Medical School in Boston, in a statement. “A growing body of evidence points to a similar conclusion: if your doctor adheres to the new recommendations for breast screening, actively seek out a formal risk assessment, whether or not it is specifically suggested, to make sure you receive the care you need.”