Jury still out on net benefit of screening younger women for breast cancer

December 07, 2006

Whether the benefits of routine annual breast screening for women aged 40-49 years outweigh the harms and costs is still unclear, according to an Article published in this week's issue of The Lancet.

Previous research has suggested that inviting women for screening between the ages of 40-49 years may be beneficial. However, this benefit could be due in part to women who were invited in their 40s but were actually screened after they were 50. Dr Sue Moss (The Institute of Cancer Research, London, UK) and colleagues designed the AGE trial to overcome this issue by only inviting women for annual mammography up to age 48.

Researchers randomly allocated over 160 900 women to receive annual mammography invitations starting at age 40 years or invitations starting at 50 years of age as in the current NHS Breast Screening Programme. The trial was undertaken in 23 NHS breast-screening units in England, Wales, and Scotland. Women were followed-up for an average of 11 years.

The investigators found that though breast cancer mortality dropped by 17% in the younger age screening group compared with the control group this was not a statistically significant result. They also found that out of 17 030 regular attenders, 23% had at least one false positive result compared with an estimated 12% of women older than 50 years screened regularly as part of the national screening programme. Other possible harmful effects of screening include the risk of radiation-induced breast cancer. However, the authors estimate that the percentage of women for whom the risk of radiation-induced breast cancer might outweigh the benefit will be very small.

The authors add that the later screens in the trial took place at 7-8 years from date of entry, and the effect of these screens is unlikely to have emerged yet.

"Future decisions on screening policy should be informed by further follow-up from this trial and should take into account the possible harms and costs as well as benefits," they conclude.

In an accompanying Comment Benjamin Djulbegovic (H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA) states: "...the decision of whether to recommend screening mammography crucially depends on estimates of harm, which will never be zero. Although the best estimates of harms from screening mammography seem to be less than the benefits, they remain too uncertain to conclude that screening mammography in this age-group is associated with a net benefit. Benefit and harms need to be contrasted with each woman's individual risks for development of breast cancer. Every woman, with her physician's guidance, should decide whether regret will be greater if she develops breast cancer that could have been detected earlier by screening mammography, or if she develops breast cancer later in life as a result of screening mammography itself." (Quote by e-mail; exact version does not appear in published Comment)
EMBARGO: 00:01H (UK time) Friday December 8, 2006. In North America the embargo lifts at 18:30H EST Thursday December 7, 2006.

Contact: Nadia Ramsey in the Press Office at The Institute of Cancer Research on 0207 153 5359 or nadia.ramsey@icr.ac.uk

Nancy E. Johnson, Media Developer, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr., MBC-PR, Tampa, Florida 33612. T): 813-745-1478 Cell: 813-484-1308


Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.