CHICAGO: Women, even if they don’t have family history of breast cancer, should undergo cancer screening or a mammography every year after reaching the age of 40.
A new study presented here on Wednesday at the annual meeting of Radiological Society of North America (RSNA) has again backed screening at 40 for breast cancer.
The study says women in their 40s with no family history of breast cancer are as likely to develop invasive breast cancer as are women with a family history of the disease.
Earlier the US Preventive Services Task Force (USPSTF) had recommended that regular breast cancer screening of women should start at the age of 50 as opposed to 40. In India, however, experts agree with 40.
“Women in India have started to get diagnosed with breast cancer, which incidentally has also become the number 1 cancer among women living in cities. To start screening at 40 will help in early diagnosis which is vital with breast cancer. No damage is recorded from radiation if taken after 10 months,” said radiologist Dr Harsh Mahajan from Delhi, who is attending RSNA.
“We believe this study demonstrates the importance of mammography screening for women in this age group, which is in opposition to the recommendations issued by the taskforce,” said Stamatia V Destounis, radiologist and managing partner of Elizabeth Wende Breast Care, Rochester.
Dr. Destounis and colleagues performed a retrospective review to identify the number and type of cancers diagnosed among women in 40-49 age group – with and without a family history of breast cancer-who underwent screening mammography at Elizabeth Wende Breast Care between 2000 and 2010. The researchers compared the number of cancers, incidence of invasive disease and lymph node metastases between the two groups.
Of the 1,071 patients in the 40-49 age group suffering from breast cancer, 373 were diagnosed due to screening. Of that 373, 39% had a family history of breast cancer. In the family history group, 63.2 % of the patients had invasive disease. In the no-family history group, 64 % of the patients had invasive disease. The lymph node metastatic rates were 31% and 29 %, respectively.
“In the 40-49 age group, we found a significant rate of breast cancer and similar rates of invasive disease in women with and without family history. “Additionally, we found the lymph node metastatic rate was similar,” Dr. Destounis said.
According to Dr. Destounis, these results underscore the importance of early detection and annual screening mammography for women in the 40-49 age group, irrespective of a family history of breast cancer.
Screening mammography – the all-important X-ray examination of breasts to check for cancer in a woman who is asymptomatic (shows no symptoms) – is abysmally low in India. According to WHO’s latest World Health Statistics (WHS), less than 5% women, aged between 50 and 69, underwent screening by mammography in India between 2000 and 2003.
Breast cancer cases are surging across the globe. The maiden global analysis that factored in the trend over the past three decades shows the number of new breast cancer cases diagnosed worldwide has increased dramatically from about 6.4 lakhs in 1980 to 16 lakhs in 2010.
On the contrary, the rise in deaths from breast cancer globally has been slower, increasing from about 2.5 lakhs in 1980 to 4.25 lakhs in 2010, possibly reflecting the effectiveness of early detection and advances in treatment in developed countries. The study, published in the British medical journal The Lancet recently, says 51% of these new cases of breast cancer occurred in developing countries like India.
Dr Vinod Raina from AIIMS said, “Western lifestyle, increased consumption of fat products, obesity, late marriages, delayed child bearing and less number of children being conceived leading to reduced breastfeeding and use of some contraceptives, are all believed to be behind this increased risk of breast cancer. This cancer is also inevitable with an ageing population.”