May 3rd, 2010
04:00 PM ET

Mammograms in your 30s: ‘A needle in a haystack’

By Sabriya Rice
CNN Medical Producer

An estimated 29 percent of U.S. women in their 30s undergo mammograms each year, but false-positives and callbacks for additional screenings are frequent, and few breast cancers are detected in women of this age group, a new study finds.

The study, published in the Journal of the National Cancer Institute, looked at 117,738 women younger than age 40 with no family history of breast cancer. Women between ages 35 and 39 underwent the highest number of mammograms, yet for every 10,000 women screened in this age group, 1,266 would be called back for additional tests and imaging and 16 cancers would be found. That number more than doubles to 43 cancers detected per 10,000 women ages 45-49, and continues to increase with age.

“The good news is that young women don’t get breast cancer at high rates,” explains Bonnie C. Yankaskas, lead author of the study, and part of the Breast Cancer Surveillance Consortium.  Breast cancer risk increases with age and for women younger than 40, “you’re looking for a needle in a haystack,” Yankaskas says. She says there needs to be serious discussion about the use of mammography in young women who do not have symptoms, to prevent exposure to unnecessary radiation.

The American Cancer Society agrees, saying this study strongly supports their recommendation that screening mammography should begin at age 40 and not earlier. “We have been concerned that some have been encouraging that screening begin at younger and younger ages, when the science does not support it as beneficial,” Dr. Otis Brawley, chief medical officer of the ACS wrote in a statement. He also notes “it is important to remember that this is a study of women who have no symptoms, and are not at high risk of breast cancer.”

Experts at the National Cancer Institute, the American Cancer Society, and the American College of Radiology recommend annual mammograms for women starting at age 40, but also encourage women in their 30s to schedule mammograms if they have factors - like a strong family history of breast cancer, exposure to previous chest radiation or they are carriers of certain genes like the BRCA1 and BRCA2 - which put them at higher risk of developing the disease.

In November 2009, the U.S. Preventive Services task force issued recommendations suggesting women in their 40s did not need routine mammograms. The recommendation led to a firestorm of criticism from those concerned that physicians and insurance companies may stop offering mammograms to women in their 40s. For more see: I want my mammograms!. The USPSTF later updated their language to say screenings for women between ages 40-49 should not be automatic, but should be a decision made on an individualized basis between the patient and her physician.

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soundoff (15 Responses)
  1. HealingNews

    The biggest problem with mammograms – They are dangerous because of the radiation, and highly invasive, sometimes leading to metastasis of otherwise benign tumors, fibroids, and cysts, that otherwise might protect the body from cancer. The best scenario – learn the alternatives, many that work better. http://www.BreastHealing.info

    May 4, 2010 at 10:49 | Report abuse | Reply
  2. Sunny

    I had a mammogram in my late 30's and was told I was fine. A couple years later, I had another one and was told it looked unusual. Turns out it was a nearly 4 cm non-palpable, stage 2 invasive breast cancer. To make matters worse, it was clearly visible on the first mammogram, but the radiologist assumed it was nothing, I guess because I was "too young", had no immediate family history of breast cancer, was normal weight, never drank or smoked and was basically very healthy (not BRCA positive either). I guess I am biased, but I implore my girlfriends (many of whom don't know I had cancer) to get mammograms in their late 30's and every couple years thereafter. Better safe than dead – I'd take a false biopsy over chemo any day. Young women who get breast cancer deserve to be diagnosed and treated – damn the actuaries who say it is too costly. What if it were their sister, wife or daughter?

    May 4, 2010 at 18:22 | Report abuse | Reply
  3. Bruce Rubin

    wait a second, it says 16 cancer positives per 10,000?? for the 30 year old demographic. Dose the National Cancer Institute suggest they are they to be sacrificed for cost savings???Wait a second, They also talk about prevent exposure to unnecessary radiation. Does this "suggest" that the screenings are a potential cancer risk??

    May 5, 2010 at 21:38 | Report abuse | Reply
  4. Marcia

    I'm one of the lucky 16. I think the recommendations make sense, to go on a case by case basis. I'm thankful that my OB/GYN recommended that once I turned 35 that I should start getting mammograms. I have a strong family history (2 grandmothers, 1 aunt).I was 25 at the time. It was my first mammogram at age 37 that caught stage 2B HER2/Neu positive cancer, a rather vigorous variety. I'm so glad I listened to my OB/GYN's voice from so many years ago. I'm done with all the treatments and have an excellent prognosis.

    May 6, 2010 at 12:57 | Report abuse | Reply
  5. Mer

    I am one of the lucky 16 as well. I was diagnosed several weeks after turning 35. My family history was paternal and not super-strong – my aunt was diagnosed at age 28 but her mother was fine (my paternal great aunts x 3 had breast CA though too). Also BRCA negative. Since it was caught I have a pretty good prognosis. So much for starting mammograms at age 50!

    May 6, 2010 at 13:59 | Report abuse | Reply
  6. kathy

    Young women who get breast cancer deserve to be diagnosed and treated Sunny you are right. I think everything should be done to save the lives of our young women.

    Ironically however when we consider this, it is odd to realize our government is spending far more to promote women's health than it does for the males since it is the male that is in more of a health care crisis and they need more help. (Not that I am complaining about this disparity as I think women are more essential to the family and to society)

    Perhaps this is because the government also realizes the value of women over the value of males and that between the two genders; the male is actually the more expandable gender as any society needs more women to carry on than it needs males... I remember one college course where the students were given a scenario whereby they came upon an accident where they could save one of two people but not both. They were to choose between saving a male vs. a woman of about the same age. 95% of the class (which was divide almost equally between males and women) said they would save the woman. This shows that even most of the males said they would save the woman over the male so I would tend to believe that even males realize that women are more essential than are males.

    May 7, 2010 at 04:18 | Report abuse | Reply
  7. Ron

    Sunny: "Young women who get breast cancer deserve to be diagnosed and treated – damn the actuaries who say it is too costly. What if it were their sister, wife or daughter"

    Sunny, although I am a male, I do agree with you that more could and should be done for our women. I know there is a limited amount of money that is avaiable but I would vote to spend more of it on our women as I do have to admit, women are needed more than us males. LOL I just noticed Kathy's statement: "This shows that even most of the males said they would save the woman over the male so I would tend to believe that even males realize that women are more essential than are males.

    She is right on target. And she is also right, I for one am a male who would save a woman over another male anyday.

    May 8, 2010 at 03:03 | Report abuse | Reply
  8. Katie

    Women have been taught in our society to treat their bodies like walking time bombs. They spend so much time checking to see if they are dying that they don't have time to live.

    November 25, 2010 at 11:57 | Report abuse | Reply
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