A new study reported that beginning breast cancer screening as early as age 25 may increase the longevity of women who carry a genetic mutation linked to a higher risk of cancer. “Results indicate that breast cancer deaths will decrease because of screening,” noted study co-author Dr. Janie Lee, who specializes in breast imaging at Massachusetts General Hospital. Breast cancer snuffs out the lives of many women each year. For example, it is the leading cause of cancer deaths and the second leading cause of death (behind coronary heart disease) in Los Angeles County. Dr. Lee and colleagues attempted to determine which breast cancer screenings, mammogram or magnetic resonance imaging (MRI), were effective in women who carry gene mutations BRCA1 and BRCA2. They reviewed case among women aged 25, 30, 35, and 40 years. The study, which was published in the September 20 issue of the journal Cancer, found that compared to no screening at all, annual screening starting at age 25 extended life by 1.3 to 1.8 years. Screening with a breast MRI every six months extended life by 1.5 to 1.7 years. Over the course of their lives, women with BRCA1 who began having mammograms at the age of 25 would have two false positives. Those women with BRCA1 who had an annual mammogram and a breast MRI would have four false positives. BRCA2 carriers who began having annual mammograms at age 25 would have three false positives; if they had both an annual mammogram and an MRI, they would have eight false positives.
The United States Preventive Services Task Force recommends breast cancer screening for all women beginning at age 50. BRCA carriers are encouraged to start screening at a young age by groups such as the American Cancer Society, which recommends screening at age 30, five years later than when the study suggests. “Starting at 25 years may have a slight benefit, but for most women 30 is good too,” said Dr. Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society. She added, “For women who have a BRCA mutation in their family, they tend to get diagnosed at age 40 or younger so they should consider screening at age 25.” The down side of annual screenings an increase in healthcare costs; furthermore, it exposes women to radiation. However, the radiation risk is quite small, when compared to the risk of dying from breast cancer if one avoids screening. When the researchers factored in radiation risk, they found fewer than 5% of women who were BRCA carriers were diagnosed with breast cancer due to exposure to radiation.
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