Dr. Elizabeth Arleo, Professor of Radiology at Weill Cornell Medicine, is the lead author on a statistical modeling study that showed receiving annual mammograms starting at age 40 would prevent more breast cancer deaths than other recommended approaches. Currently, the medical community lacks consensus on the optimal screening process. However, having annual screening mammograms beginning at 40 comes with significant physical, psychological and monetary costs.
Benefits and Costs of Additional Screening
The Centers for Disease Control and Prevention (CDC) report that breast cancer is the most common cancer in women and is second to lung cancer as the cause of death. Researchers have been working for years to determine the optimal screening process to identify and treat breast cancer in its earlier stages when treatment is most effective. Currently, different organizations have conflicting recommendations. The US Preventive Service Task Force recommends screening every two years for women between 50 and 74 while the American College of Obstetricians-Gynecologists suggests annual screening for females between the ages of 40 and 74. The American Cancer Society advocates that women 45 to 54 get annual screening while those 55 and older switch to biannual.
Dr. Arleo and her team used statistical models developed by the Cancer Intervention and Surveillance Modeling Network (CISNET) to determine the mortality rates for the three described recommendations. They found a 39.6% reduction in breast cancer mortality for the annual exam beginning at age 40 compared to a 23.2% reduction for biennial screenings beginning at age 50. However, the reduced mortality comes with the cost of three times as many false positives and almost four times as many benign biopsies. The study also considered the best time to stop having screening mammograms and found that having a life expectancy of 5-7 years was optimal.
Statistical models look at how a choice affects a population and cannot be directly related to an individual patient. A woman considering starting annual mammograms at age 40 needs to discuss with her doctor the tradeoffs between possible false positives and unneeded biopsies with the increased opportunity to identify early stage breast cancer.
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