RSNA: Study refutes USPSTF mammo recommendations

CHICAGO – Women in their 40s with no family history of breast cancer are just as likely to develop invasive breast cancer as are women with a family history of the disease, according to a study presented Nov. 29 at the 97th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA). These findings indicate that women in this age group would benefit from annual screening mammography.

"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 U.S. Preventive Services Task Force (USPSTF) in 2009," said Stamatia V. Destounis, MD, radiologist and managing partner of Elizabeth Wende Breast Care, in Rochester, N.Y.

Destounis admitted that the data, which confirmed that most women in their 40s diagnosed with breast cancer do not have a family history of breast cancer, suprised researchers.

The researchers performed a retrospective review to identify the number and type of cancers diagnosed among women between the ages of 40 and 49—with and without a family history of breast cancer—who underwent screening mammography at Elizabeth Wende Breast Care from 2000 to 2010. The researchers then 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 to 49 age group with breast cancer, 373 were diagnosed as a result of screening. Of that 373, 39 percent had a family history of breast cancer, and 61 percent had no family history of breast cancer. In the family history group, 63.2 percent of the patients had invasive disease, and 36.8 percent had noninvasive disease. In the no family history group, 64 percent of the patients had invasive disease, and 36 percent had noninvasive disease. The respective lymph node metastatic rates were 31 percent and 29 percent.

"Family history does not seem to impact the rate of invasive disease in women aged 40 to 49," said Destounis. "Additionally, we found the lymph node metastatic rate was similar."

According to Destounis, these results underscore the importance of early detection and annual screening mammography for women between the ages of 40 and 49 whether or not they have a family history of breast cancer.