Earlier Mammography Screening Results in Greater Mortality Reduction

September 6, 2018

Screening at age 40 detects more stage 1 breast cancers.

The greatest mortality reduction based on stage of breast cancer diagnosis is achieved when mammographic screening starts at age 40, according to a study published in the Journal of the American College of Radiology.

Researchers from Elkhart General Hospital in Indiana sought to compare overall and stage I to IV mortalities of patients diagnosed with breast cancer, calculated from stage at diagnosis using the Surveillance, Epidemiology, and End Results (SEER) database stage mortality estimates.

Data included in the study were from 445 new breast cancer patients between 2010 and 2014. The researchers looked at percentages of invasive cancers, stage 0 + I of total cancers, and stage I of invasive cancers. Five-year estimated overall and invasive mortalities were calculated based on stage at diagnosis and SEER survival data. Program categories defined included an annual program, based on the ACR (annual screening age 40 and above), a biennial program, based on the US Preventative Services Taskforce (biennial screening ages 50 to 74 years), and a hybrid program, based on the American Cancer Society (annual screening ages 45 to 54 years, then biennially at ages 55 and above), including respective interval cancers.

The results showed that when the program categories were compared,
the annual program had the lowest percentage of invasive cancers (75.3 percent), highest percentages of stage 0 + I of total cancers (75.3 percent) and stage I of invasive cancers (67.1 percent). The annual program also had the lowest 5-year estimated overall (10.1 percent) and stage I to IV (12 percent) mortalities.

The estimated overall and stage I to IV mortalities for the annual program was 37.3 percent and 30.6 percent less, respectively, than the biennial program, and 31.8 percent and 26.8 percent less, respectively, than the hybrid program.

The researchers determined that when based on stage at diagnosis, the greatest mortality reduction is achieved with mammography utilization starting at the age of 40.