Instead, a mammogram schedule should be personalized for each patient and should consider several factors including age, breast density, family history and lifestyle.
That is the recommendation of a new study in the latest issue of the Annals of Internal Medicine.
The study challenges current guidelines from the US Preventive Task Force, which calls for screening women 50-74 years of age every two years.
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"Most guidelines use age as the determining factor in when, and how often, a woman should get a mammogram," says Steve Cummings, MD, of the San Francisco Coordinating Center at the California Pacific Medical Center Research Institute and the lead author of the study. "What our study shows is that other factors, particularly breast density, are just as important, if not more so, in helping a woman decide what is most appropriate for her. We show that mammography should be personalized. The best interval for you depends on your age, breast density, and other risk factors for breast cancer."
Several studies have shown that the denser a woman's breast, the greater her risk of breast cancer.
Researchers looked at data from Breast Cancer Surveillance Consortium and Surveillance Epidemiology and End Results of the National Cancer Institute. They developed a model to compare the costs and health benefits for women who got mammograms yearly, every two years, every three to four years or never. Risk factors for the women were all different and they fell into several categories from remaining healthy to having one of four types of breast cancer.
"Our analysis suggests that women with a first-degree relative with breast cancer or with a history of a breast biopsy should have an initial screening mammography at age 40,'' said study co-author Karla Kerlikowske, MD, MS, an expert in mammography at the University of California, San Francisco.
"For women age 40 to 49 with high breast density and with either a first-degree relative with breast cancer or a prior breast biopsy, the benefits versus harm for performing mammography every two years is similar to screening an average-risk woman in her 50s."
For women age 40 to 49 without these risk factors, the study says it is reasonable to wait until age 50 to start mammography screening.'
Dr. Susan Love, author of Dr. Susan Love's Breast Book and President of the Dr. Susan Love Research Foundation said, "This is exactly the type of analysis that we need if we are going to help women and doctors figure out the best schedule of screening for them. Personalized medicine extends beyond treatment to risk definition and appropriate screening schedules. "
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