Routine mammography for women aged 40-49 years: should mammography screening guidelines be changed in view of current research?
- L Nimmo1
© Current Science Ltd 2000
Published: 1 October 2000
The objective of this study was to establish that current guidelines excluding women aged 40-49 years from the National Breast Screening Programme (NBSP) are justified. Since the conception of the NBSP many articles have been published to fuel the debate on routine mammography for women aged 40-49 years. This study evaluates some of the relevant issues to facilitate making an informed decision on the minimum age for routine screening.
The relevant issues chosen were: reduction in mortality, screening interval related to tumour growth, ductal carcinoma in situ (DCIS), density of breast parenchyma, false-positive mammograms, cost-effectiveness and radiation-induced breast cancer. A collation of the issue summaries identifies that screening women from the age of 40 years does reduce mortality. However, this has to be balanced against: (1) the possibility of overtreatment from an increase in both detection of DCIS and false-positive mammograms and (2) radiation-induced cancers. The study concludes that at present there is insufficient evidence to reduce the age of inclusion in the NBSP. Any new research has to be kept under review and changes implemented as necessary.
Three areas were highlighted as the main influences for future changes: (1) research focused for this age group; (2) research distinguishing invasive from non-invasive DCIS; and (3) changes in equipment and technique.