Study Supports Breast Cancer Screening for Women in 40s

CHICAGO - Women in their 40s without a family history of the disease face the same risk for breast cancer and should be screened, according to a study released at RNSA Tuesday

“Family history does not seem to impact the rate of invasive disease in our patient cohort,” said Stamatia Destounis, MD, radiologist and managing partner of the Elizabeth Wende Breast Care Center, whose study found women between the ages of 40 and 49 showed the same rates of cancer regardless of history.

Destounis and colleagues conducted a retrospective study on patients diagnosed with breast cancer at their center from 2000 to 2010. Three hundred seventy-three patients obtained their diagnosis through mammography screening out of 1,071 total patients diagnosed with breast cancer. Of those 373, 144 patients, or 39 percent, had a family history of breast cancer, with seven of them having a personal history of breast cancer. There were 228 patients, or 61 percent, with no family history, 16 of whom had a personal history. There was one with an unknown family history.

Of the 144 patients with a family history of breast cancer, 46 patients, or 31.9 percent, had a premenopausal history among first degree relatives. This meant that they had a young family member with breast cancer. Another 54 patients, or 37.5 percent, had a postmenopausal history. Lastly, 44 patients, or 30.6 percent, had pre- or postmenopausal history in a second or third degree relative.

In the non-history group, there were 86 masses, 97 microcalcifications, 18 masses with calcium, 18 architectural distortions, and nine asymmetries. In the group with family history, there were 42 masses, 69 microcalcifications, 21 masses with calcium, 11 architectural distortions, and one asymmetry. Types of lesions between the two groups were statistically different.

Analysis showed that in the non-history group, 146 patients, or 64 percent, had invasive disease, and 36 percent had noninvasive disease. In the group with family history, 91 patients, or 63.2 percent, had invasive disease, and 36.8 percent had noninvasive disease. In the non-history group, a total of 71 patients, 31.1 percent, had a mastectomy. In the group with family history, 54 patients, or 37.5 percent, had a mastectomy.

The study also looked at lymph node metastatic rates, and found the rates to be 29 percent for non-history and 31 percent for family history groups. The research group also collected data on breast density and demographics of the patients, and are in the process of collecting recurrence and survival rates.

Breast cancer is the most common cancer diagnosis among women in the U.S., comprising 30 percent of all diagnoses, according to the American Cancer Society. It is the second leading cause of death in women.

This study supports the American Cancer Society's recommendation for all women 40 and over to get an annual mammography screening. This is in contrast to the guidelines issued by the U.S. Preventive Services Task Force, which recommend an individualized choice.