Why Should You Get a Screening Mammogram Starting at Age 40?

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  • The Swedish Two-County Trial was the first breast screening trial to demonstrate a reduction in breast cancer mortality from screening mammography alone:
    • Showing a 30% reduction in mortality among women aged 40 to 74 years invited to screening:
      • Three decades of follow-up on this study have shown a stable effect upon mortality reduction and an increased absolute benefit in terms of lives saved.
  • Mammographic screening:
    • Has been shown to be associated with a reduction in breast cancer mortality across a range of study designs:
      • Including randomized controlled trials and observational studies.
    • Although specific estimates vary, a meta-analysis of eight randomized trials demonstrated:
      • A 14% to 32% mortality reduction among women invited to screening compared with women who were not invited.
    • A recent Norwegian prospective cohort study:
      • Found invitation to modern mammography screening resulted:
        • In a 28% decrease in mortality.
    • An Australian case-control study and meta-analysis of women participating in organized clinical screening programs showed:
      • A 49% mortality reduction.
    • The Swedish Organised Service Screening Evaluation Group:
      • In an incidence-based mortality study:
        • Demonstrated a mortality reduction of 40% to 45% in women screened.
  • According to these mammography screening trials:
    • The overall reduction in breast cancer mortality gained in populations screened with mammography:
      • Is between 14% to 49%
  • References:
    1. Helvie MA, Chang JT, Hendrick RE, Banerjee M. Reduction in late-stage breast cancer incidence in the mammography era: implications for overdiagnosis of invasive cancer. Cancer. 2014;120:2649-2656.
    2. Nelson HD, Tyne K, Naik A, Bougatsos C, Chan BK, Humphrey L; U.S. Preventive Services Task Force. Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med. 2009;151:727-737.
    3. Nickson C, Mason KE, English DR, Kavanagh AM. Mammographic screening and breast cancer mortality: a case-control study and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2012;21:1479-1488.
    4. Oeffinger KC, Fontham ET, Etzioni R, et al; American Cancer Society. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA. 2015;20;314:1599-1614.
    5. Swedish Organised Service Screening Evaluation Group. Reduction in breast cancer mortality from organized service screening with mammography: 1. Further confirmation with extended data. Cancer Epidemiol Biomarkers Prev. 2006;15:45-51.
    6. Tabár L, Fagerberg CJ, Gad A, et al. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet. 1985;13:829-832.
    7. Tabár L, Vitak B, Chen TH, et al. Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades. Radiology. 2011;260:658-663.
    8. Weedon-Fekjær H, Romundstad PR, Vatten LJ. Modern mammography screening and breast cancer mortality: population study. BMJ. 2014;348:g3701.

 

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