New Study Supports Annual Breast Cancer Screening for Women Over 40

PITTSBURGH, Aug.26, 2024 - Women diagnosed with breast cancer who had regular screening mammograms every yearwere less likely to have late-stage cancer and had higher overall survival than those who received screening every other year or lessoften, according to new research from the University of Pittsburgh and UPMCpublished in the Journal of Clinical Oncology.

"Only about 65% of women over age 40 are screened for breast cancer, and only about half of those women are getting annual screening- in part because ofconflicting guidelines about recommended screening intervals," said lead author Margarita Zuley, M.D., professor and chief of theDivision of Breast Imaginginthe Department of Radiology at Pitt and UPMC. "Our study shows that there is a significant benefit for annual screening over biennial screening, including in premenopausal women." [Link]

While many clinical trials have demonstratedthe benefits of mammography screening for breast cancer, guidelines differ on how often women shouldbe screened.The American College of Radiology and several other organizations adviseannual screening after age 40, whereasthe U.S. Preventive Services Task Force recommends biennial screening from age 40.

Becausethe U.S. does not have a national breast cancer registry, Zuleyand her team recently developed a large institutional databaseto better understand real-world outcomes for breast cancer patients.

To gain more evidence on optimalmammography screening intervals, the researchers used this database to compare 8,145 breast cancer patients who had at least one mammogram on record prior to diagnosis. The screening interval was consideredannual if the time between mammograms was less than 15 months, biennial if between 15 and 27 monthsand intermittent if greater than 27 months.

The percentage of late-stage cancers- TNM stageIIB or worse -was 9%, 14% and 19% for annual, biennialand intermittent screening groups, respectively. Biennial and intermittent groups had substantially worseoverall survival than the annual group.

"The percentage of late-stage cancers increased significantly with increased screening intervals," said Zuley. "Annual mammograms are crucial for early detection of breast cancer, which increases the likelihood of survival, decreases harms to patients because treatment may not need to be as intense, makes recovery easier andcan lower thecost of care."

One concern with morefrequent mammograms is the increasedriskof false positives, leading to unnecessary biopsies and anxiety.

"We recognize that there are potential harms associated withcallingwomen back for additional screening, but I don't think that these harms outweigh the risk of missing cancersand womendying as a result," said Zuley."We're also working on testingscreening tools that have lower false positives than mammographyand pushing on every front to identify the most cost-effective and accurate way of taking care of our patients."

Other authors on the study wereAndriy Bandos, Ph.D.,Durwin Logue, Rohit Bhargava, M.D., Priscilla McAuliffe, M.D., Ph.D., Adam Brufsky, M.D., Ph.D., and Robert M. Nishikawa, Ph.D., all of Pitt and UPMC;and Stephen Duffy, Ph.D., of Queen Mary University of London.

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