Mammograms Before Age 40 May Not Be Appropriate

Screening mammograms in young women result in high recall, low cancer detection rates
By Lindsey Marcellin
HealthDay Reporter

FRIDAY, May 14 (HealthDay News) -- Screening mammography for women under age 40 results in high rates of recall and additional imaging but low cancer detection rates, according to research published online May 3 in the Journal of the National Cancer Institute.

Bonnie C. Yankaskas, Ph.D., of the University of North Carolina at Chapel Hill, and colleagues reviewed the records of 117,738 women aged 18 to 39 years who had their first diagnostic or screening mammogram between 1995 and 2005. Measured end points were recall rate and mammographic sensitivity, specificity, positive predictive value, and cancer detection rate.

The researchers note that no cancers were detected in any of the screening mammograms on the youngest (aged 18 to 24) women. For the oldest subgroup (aged 35 to 39), the cancer detection rate was 1.6 per 1,000 screening mammograms, while the recall rate was 12.7 percent, the sensitivity was 76.1 percent, the specificity was 87.5 percent, and the positive predictive value was 1.3 percent. For diagnostic mammograms -- those done because a woman had a sign or symptom such as a lump -- the age-adjusted cancer detection rate and positive predictive value were better (14.3 per 1000 mammograms and 14.6 percent, respectively); sensitivity and specificity were 85.7 percent and 88.8 percent, respectively.

"With high recall and low cancer detection rates, many young women, who are at low or average risk for breast cancer, are having additional imaging as a result of undergoing screening mammography, with a low probability of cancer detection. Who should be screened for breast cancer at younger ages and how best to screen them remain important research questions," the authors write.

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