Screening mammography in women ages 40 to 49 finds almost 20% more cancers than screening in women ages 50 and older, according to a presentation delivered at the American Roentgen Ray Society (ARRS) meeting in Washington, DC.
Furthermore, this boost in cancer detection increases the recall rate by only 1.5% and the biopsy rate by 0.1%, wrote a team led by Dr. Abid Irshad from the Medical University of South Carolina.
To investigate the effectiveness of screening mammography for women ages 40 to 49 years (group A) in comparison with women ages 50 to 59 (group B) and 60 to 69 (group C), Irshad's team included data from 41,028 mammography exams performed at their facility between October 2011 and June 2017. The researchers calculated the number of mammograms performed, the recall rate, the number of biopsies performed, the number of cancers detected, and the modality's sensitivity and specificity for each age group.
The overall recall rate across all age groups was 12.7%, and the biopsy rate was 2.8%. From all the mammograms performed, 326 cancers were identified.
The researchers also found the following:
- Group A (40-49 years) had 8,913 mammograms, with 52 cancers detected.
- Group B (50-59 years) had 13,288 mammograms, with 103 cancers detected.
- Group C (60-69 years) had 12,119 mammograms, with 89 cancers detected.
Overall, women ages 50 and older had 31,385 mammograms with 270 cancers detected, a recall rate of 11.2%, and a biopsy rate of 2.7%, the researchers found. Adding women between the ages of 40 and 49 into the screening population of 50 and older increased the overall recall rate from 11.2% to 12.7% and the biopsy rate from 2.7% to 2.8%, but it also boosted the cancer detection rate by 19.3%, Irshad and colleagues wrote.
| Effectiveness of screening mammography by age range | |||
| Ages 40-49 | Ages 50-59 | Ages 60-69 | |
| Sensitivity | 86.7% | 94.5% | 89.9% |
| Specificity | 96.8% | 97.8% | 98.2% |
| Recall rate | 17% | 12.5% | 10.2% |
| Biopsy rate | 3.4% | 2.8% | 2.5% |
"When compared to screening population ages 50 and over, screening mammography in women ages 40 to 49 detects 19.3% additional cancers at the expense of an overall 1.5% increased callbacks and 0.1% increased biopsies," the team concluded.
