Women in their 40s with no family history of breast cancer are just as likely to develop invasive breast cancer as women whose mother or sister has had the disease, according to a new study.
These preliminary findings support a recommendation for all women 40 to
49 to get annual mammograms, not just those with a family history of
breast cancer, said Dr. Stamatia V. Destounis, a Rochester, N.Y.,
radiologist. Women with no family history are typically considered
low-risk.
Destounis evaluated cancer patients who were seen from 2000 to 2010 at
the Elizabeth Wende Breast Care facility, where she is a managing partner.
"Invasive cancer [cancer that spread to the lymph nodes] was diagnosed
in 64 percent of patients without family history and 63 percent with," she
said.
She is scheduled to present her findings Tuesday at the annual meeting
of the Radiological Society of North America in Chicago.
During the decade studied, 373 women 40 to 49 years old were diagnosed
with breast cancer after mammography screening at the center. Of the
nearly 40 percent who had a family history (meaning a primary relative
with the disease), 63.2 percent had invasive breast cancer, while in the
no-family-history group, 64 percent of the patients had invasive disease.
(Of those without a family history, 16 had a personal history of breast
cancer.)
When the researchers looked at the cancers' aggressiveness, they found
29 percent of cancers in women without a family history and 31 percent of
those with a family history had spread to the lymph nodes.
While some experts agree with Destounis that annual mammograms should
begin at 40, others do not. The American Cancer Society recommends annual
screening with mammograms for women starting at age 40. However, the U.S.
Preventive Services Task Force recommends women 40 to 49 discuss screening
with their doctor and then decide. The Canadian Task Force on Preventive
Health Care earlier this month recommended that women age 40 to 49 at
average risk not get routine mammograms.
"I don't see that this study helps inform a woman about whether she
should start mammograms at age 40 or at age 50," said Dr. Michael LeFevre,
co-vice-chair of the U.S. Preventive Services Task Force. One limitation
of the study is that it was conducted at a single facility, a limitation
that Destounis acknowledges. However, she said the women are ethnically
diverse and from all income levels.
The study finding, LeFevre said, ''doesn't say anything about the
probability of a woman dying in her 40s."
LeFevre also pointed out that "having an aunt die of breast cancer at
age 85 is not the same as having a mother or sister with breast cancer at
42," when it comes to family history. When a woman discusses with her
doctor when she should begin mammograms, LeFevre said that discussion
should definitely include details about family history.
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