Based on a new study published online in the journal Cancer, a large number of deaths caused by breast cancer happen in young women who do not undergo or receive regular mammograms.
The Centers for Disease Control and Prevention (CDC) first reported that there were more than 18.7 million mammograms performed or provided throughout 2010. However, in this most recent study, researchers claim that there is a great shortage of mammograms provided to women under the age of 50.
Researchers from Harvard Medical School in Boston carried out an examination on the value of mammography screening, employing a method called "failure analysis.”
This method assesses breast cancer cases in reverse, beginning from death, in order to determine links at diagnosis, rather than looking forward from the beginning of a study.
Invasive breast cancer cases that were diagnosed at Partners HealthCare Hospitals in Boston between 1990 and 1999 were evaluated for the study. The researchers analyzed the patients':
• Mammography use
• Surgical and pathology reports, and
• Recurrence and death dates
From 609 verified deaths caused by breast cancer, only 29% of the women were revealed to have been screened with mammography, while the remaining 71% went unscreened.
Out of all breast cancer related deaths, 13% happened in women older than the age of 70, while 50% occurred in women younger than the age of 50. The women diagnosed with breast cancer who later died were an average age of 49 at the time of diagnosis. While those women who died from other ailments had their diagnosis at an average age of 72.
"The biological nature of breast cancer in young women is more aggressive, while breast cancer in older women tends to be more indolent. This suggests that less frequent screening in older women, but more frequent screening in younger women, may be more biologically based, practical, and cost effective,” said professor of surgery (emeritus) of Harvard Medical School, Dr. Blake Cady.
Moreover, the study revealed that since the introduction of breast cancer screening in 1969, survival from the disease has dramatically increased.
In 1969, 50% of women diagnosed with breast cancer died 12.5 years following diagnosis, compared with only 9.3% of women from this study, who were diagnosed between 1990 and 1999.
"This is a remarkable achievement, and the fact that 71% of the women who died were women who were not participating in screening clearly supports the importance of early detection," noted Daniel Kopans of Harvard Medical School and Massachusetts General Hospital.
In 2009, the US Preventive Services Task Force suggested that mammography should be limited to women aged between 50 and 74. However, research presented by the Mayo Clinic last year showed that the number of women in their 40s who have mammographies has dropped by 6% across the country since the proposition.
Researchers say that because of the findings of this recent study, there should be less focus on ensuring older patients are screened, and more focus on younger women being screened, or striking a suitable balance between the two.
"Detecting and treating breast cancer in younger women to prevent death may further increase the disease-free life years saved. Our findings suggest decreasing the intensity of efforts to screen women older than 69 years while concomitantly emphasizing efforts to screen younger women in particular,” said the researchers.
Yet, other studies have refuted the claim over screening more mammograms, as research from The Dartmouth Institute for Healthy Policy & Clinical Practice in Lebanon contested that mammograms do not effectively reduce breast cancer death rates and excessive mammography screening can lead to unnecessary over-diagnosis.