Should Screening Age for Women With Family Breast Cancer History Be Lower?

By Lou Portero - Last Updated: December 16, 2022

A new study published in the American Cancer Society journal Cancer reconsiders when to begin mammogram screening if a woman has a first-degree family relative diagnosed with breast cancer.

Breast cancer screening guidelines recommend that women whose sister, mother, or daughter have been diagnosed with breast cancer and are otherwise at average risk get screened ten years earlier than the relative diagnosis age. However, there is little evidence to support the long-standing recommendation.

Diana Miglioretti, a UC Davis Comprehensive Cancer Center researcher, joined Danielle Durham, with the Department of Radiology at the University of North Carolina at Chapel Hill, and five other researchers to evaluate when screenings should begin for women with a family history of breast cancer.

The researchers analyzed over three hundred thousand patient data from the Breast Cancer Surveillance Consortium on screening mammograms conducted from 1996 to 2016. The national study involved over three hundred thousand women. The researchers then compared the cumulative 5-year breast cancer incidence among women with and without a first-degree family history of breast cancer by their relative’s age at diagnosis and screening age.

The researchers concluded that women whose relatives were diagnosed with breast cancer before the age of forty-five should consider screening five to eight years before their relative’s diagnosis year rather than a decade earlier as recommended. However, this should be done after consultation with her doctor. According to Danielle Durham, one of the study’s authors, “women who are at that age have a risk that is equal to that of an average-risk woman who is age 50, which is the most recommended age for starting mammograms.”

Furthermore, the researchers found that women who carry the BRCA mutation gene may benefit from starting screening earlier. In addition, they recommend that women between the ages of 30 and 39 who have more than one first-degree relative diagnosed with breast cancer consider genetic counseling.

According to the researchers, early breast cancer screenings may be less risky if the screening age is raised. These include increased radiation exposure and false positive results that force women to return to the clinic for diagnostic imaging and possibly invasive treatments without a breast cancer diagnosis. In addition, early mammograms mean more screenings during a woman’s lifetime, increasing her chances of developing these risks.

“Mammography also may not perform as well in younger women because they are more likely to have dense breasts, which increase the difficulty of finding cancer on the images and result in more false-positives,” Miglioretti said.


Source: Medical Net News

Journal Source: ACS Journals

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