In a recent analysis of information from nearly 6,000 women with breast cancer, researchers found that women younger than 50 were more likely to be diagnosed with breast cancer by feeling the tumor in the breast (called palpation) than with mammography when compared with women older than 50. This study used a statewide breast cancer registry from the Michigan Breast Oncology Quality Initiative to look at breast cancer diagnosis and treatment information to find out how the 2009 changes to the U.S. Preventive Services Task Force (USPSTF) breast cancer screening recommendations might affect how women find breast cancer, particularly those between ages 40 and 49. The USPSTF recommends that mammograms should be given every two years for women ages 50 to 74, and that women age 40 to 49 should not be offered regular mammography but should discuss the risks and benefits with their doctors. The recommendations also discourage teaching breast self-examination.
In this study, researchers found that most (81%) of the women who had tumors found by mammography were older than 50 and 19% were younger than 50. Of the women with tumors found by palpation, 40% were younger than 50.
In addition, women whose tumors were discovered by palpation were diagnosed with more advanced stages of cancer than those diagnosed with mammography. Half (50%) of the women with tumors found by palpation had stage II cancer, compared with 18% of women with tumors found on mammography. Also, 17% of women with tumors found by palpation were diagnosed with stage III cancer, compared with 4% of women whose tumors were found by mammography. As a result, researchers learned that patients whose tumors were found with palpation were more likely to have a mastectomy (removal of the breast with surgery) and chemotherapy than those whose tumors were found by mammography.
What this means for patients
“While there has been ongoing debate about when and how breast cancer screening should occur, this study shows that women who undergo regular mammography screening are diagnosed at earlier stages and often need less aggressive treatment than those who do not. This is true for women older than 50, as well as women aged 40 to 49 years for whom routine mammography is now not recommended,” said lead author Jamie Caughran, MD, Medical Director of the Comprehensive Breast Center at the Lacks Cancer Center in Grand Rapids, Michigan.
Questions to ask your doctor
- What is my risk of breast cancer?
- Do you recommend breast cancer screening? How often? When should it start?
- What are the risks and benefits of screening for breast cancer?
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