At-risk women can benefit from starting mammograms at age 30

  • Lee CS & al.
  • J Am Coll Radiol
  • 18 Sep 2019

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

  • Women aged 30-39 years with certain risk factors have the same cancer detection rate (CDR) and recall rate (RR) as average-risk women aged 40-49 years.

Why this matters

  • Findings suggest that women with 1 or more of 3 risk factors (family history, personal history of breast cancer, dense breasts) will likely benefit from screening starting at age 30 vs 40 years.
  • Other studies find that screening at age
  • Findings are consistent with recommendations of the American College of Radiology, the American Cancer Society, and the National Comprehensive Cancer Network, among others.

Study design

  • Retrospective cohort of 2.65 million women with nearly 6 million screening mammograms in the National Mammography Database, 2008-2015.
  • Funding: American College of Radiology; University of California, San Francisco.

Key results

  • Overall, mean CDR was 3.69 (95% CI, 3.64-3.74) per 1000; RR was 9.89% (95% CI, 9.87%-9.92%).
  • Overall positive predictive values for biopsy recommended (PPV2) was 20.1% (95% CI, 19.9%-20.4%), and biopsy performed (PPV3) was 28.2% (95% CI, 27.0%-28.5%).
  • Women aged 30-39 years with ≥1 of the 3 risk factors had similar CDRs and RRs as average-risk women aged 40-49 years.

Limitations

  • Retrospective, observational design.
  • No data on mortality.