Breast Cancer Screening For Women Ages 40-49--NIH Consensus Statement

Abstract

For 2 days, January 21 and 22, a panel of experts representing specialties in women's health, oncology, radiology, epidemiology, and public health listened to presentations by researchers and to public discussion and debate designed to reach a consensus on 5 questions: (1) Is there a reduction in breast cancer mortality due to screening women ages 40-49 with mammography, with or without physical examination? (2) What are the risks associated with screening women ages 40-49 with mammography and with physical examination? (3) Are there other benefits? If so, what and how do they change with age? (4) What is known about how the benefits and risks of breast cancer screening differ based on known risk factors for breast cancer? (5) What are the directions for future research? On January 23, the panel issued a consensus statement concluding that, while mammography has been shown to be clearly effective in reducing cancer mortality in women ages 50-69, there is no difference in breast cancer death within 7 years between 40- to 49-year-old women assigned to receive or not receive screening. For women in their 40s, the potential benefits of earlier diagnosis and breast-conserving therapy must be weighed against the potential risks of mammograms, including discomfort, inconvenience, radiation, and false reassurance given to women with false-negative screens. At the present time, the available data do not warrant a single recommendation for mammography for all women in their 40s. Each woman should decide for herself whether to undergo mammography.