Health Magazine

A Justification for Frequent Mammograms

Posted on the 11 January 2014 by Jean Campbell


For years, 15 to be exact, I have been grateful that a annual mammogram found my cancer before it could be felt; before it had spread to my lymph nodes, before it required chemotherapy.

My second breast cancer, a second primary, in the opposite breast, was found four years ago in a routine annual mammogram. Once again, it couldn’t be felt; it hadn’t spread to my lymph nodes; it didn’t require chemotherapy.

So, when I read the following press release, on a new study that supports the importance of frequent mammograms, I had to share.

WEDNESDAY, Dec. 4, 2013 (HealthDay News) — Breast cancer patients who have mammograms every 12 to 18 months have less chance of lymph node involvement than those who wait longer, therefore improving their outlook, according to an early new study.

As breast cancer progresses, cancer cells may spread to the lymph nodes and other parts of the body, requiring more extensive treatment.

“We found doing mammograms at intervals longer than one and a half years essentially does affect patient prognosis,” said study researcher Dr. Lilian Wang. “In our study, those patients were found to have a significantly greater lymph node positivity.”

From 2007 to 2010, Wang evaluated more than 300 women, all of whom were diagnosed with breast cancer found during a routine mammogram. She divided them into three groups, based on the interval between mammograms: less than one and a half years, one and a half to three years or more than three years. Most women were in the first category.

Wang looked to see how many women had cancer that had spread to their lymph nodes. Although nearly 9 percent of those in the shortest interval had lymph node involvement, 21 percent of those in the middle group and more than 15 percent in the longest-interval group did.

The stage at which the cancer was diagnosed did not differ among the groups, she found.

Although the study found an association between more frequent screenings and less lymph node involvement among breast cancer patients, it did not establish a cause-and-effect relationship.

Wang, an assistant professor of radiology at Northwestern University’s Feinberg School of Medicine, is scheduled to present the findings Wednesday at the annual meeting of the Radiological Society of North America, in Chicago.

The best interval between routine mammograms has been a point of discussion and debate for years.

In 2009, the U.S. Preventive Services Task Force, an independent group of experts, changed their recommendations, which previously advised annual mammograms. The updated recommendations advised that women begin routine mammograms at age 50, and that every two years was an acceptable interval. Women aged 40 to 50 were advised to discuss the pros and cons of screening with their doctors.

The updated guidelines took into account death from breast cancer with different screening intervals and the downsides of false positives, which could translate into more testing, expense and anxiety.

Other organizations, however, including the American Cancer Society and the American College of Radiology, continue to recommend annual mammograms for women beginning at age 40.

The new results, Wang said, support the recommendations for annual testing beginning at age 40 for average-risk women.

An expert not connected with the new study said its focus — looking not at the risk of death from breast cancer, but the chances of cancer spreading to the lymph nodes — is a legitimate one.

“If you catch someone with early stage cancer, they are going to need less extensive surgery, and maybe no chemo,” said Dr. Laura Kruper, director of the Cooper-Finkel Women’s Health Center at the City of Hope Cancer Center, in Duarte, Calif.

“The new study adds more power behind the fact that we do need screening mammograms starting at age 40 and every year,” she said.

Source: Office on Women’s Health, U.S. Dept of Health and Human Services

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