Annual screen benefits young women with family history of breast cancer

  • Evans DG & al.
  • EClinicalMedicine
  • 1 Jan 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Annual mammography detects breast cancer at an early stage and may reduce mortality in young women (aged 35-39 years) at increased familial risk.

Why this matters

  • National Institute for Health and Care Excellence guidelines do not routinely recommend mammographic screening in women aged
  • This study suggests that annual mammographic screening of high-risk young women is beneficial.

Study design

  • Prospective cohort (FH02) of 2899 young women without breast cancer but at high familial risk recruited at 34 UK centers and followed for a mean of 5.35 years.
  • Funding: Breast Cancer Now.

Key results

  • Cohort underwent 12,086 screening mammograms over the course of 13,365.8 years.
  • 50/55 breast cancers were screen-detected in 54 women.
  • Of 50 cancers, 35 were invasive.
  • 80% of 35 invasive cancers were detected at ≤2 cm; 80% were lymph-node negative.
  • Compared with age-matched unscreened high-risk women from the Prospective Outcomes in Sporadic vs Hereditary breast cancer (POSH) cohort, invasive tumors in women in FH02 were smaller (≤2 cm; 80% vs 45% in POSH; P<.0001 and less likely to be lymph-node positive vs in posh p=".0002).</li">
  • Actual mortality in POSH was nonsignificantly higher than FH02 (HR, 4.8; 95% CI, 0.7-34.8).
  • Projected mortality in FH02 was nonsignificantly lower than POSH (HR, 0.72; 95% CI, 0.49-1.07).

Limitations

  • Observational design.