Screening mammograms catch second breast cancers early

Feb 22, 2011

More women are surviving longer after having early-stage breast cancer, but they are at risk of developing breast cancer again: a recurrence or a new cancer, in either breast. Annual screening (a.k.a. "surveillance") mammography has long been standard for these women, but only scant evidence on screening outcomes supported this practice. In the February 23, 2011 Journal of the American Medical Association, the most comprehensive relevant study to date shows yearly mammograms do detect second breast cancers early.

The Breast Cancer Surveillance Consortium (BCSC) study examined 12 years of information from 58,870 screening in 19,078 women who had had early-stage breast cancer—and an equal number of screening mammograms in 55,315 women who had no such history and were matched for breast density, age, BCSC registry, and year of .

With her BCSC colleagues, Nehmat Houssami, MBBS, PhD, an associate professor at the University of Sydney's School of Public Health and Sydney Medical School and a physician at the Royal Hospital for Women, in Australia, found that women with a personal history of breast cancer had double the cancer rates as those with no such history. Women who had had breast cancer had 655 second cancers within a year of screening mammography, and those with no prior breast cancer had 342 cancers, with cancer rates of 10.5 vs. 5.8 per 1,000 screens, respectively.

"The comprehensive data from the BCSC made it possible for us to carefully examine the outcomes of screening for both the previously affected (conserved) breast, as well as the opposite breast, at a population level," Dr Houssami said. "This is the first study in the world, to our knowledge, to provide a complete picture of the expected outcomes of mammography screening for women with a personal history of breast cancer."

"Mammography was effective at finding cancers early in women who had had cancer, but not quite as effective as in those who had not," Dr. Houssami said, "We found that both false positives and 'interval cancers' were higher, and mammography was not as sensitive at detecting invasive breast cancer, in women with a personal history of breast cancer." False positives mean that a mammogram suggests a breast cancer may be present, but after further testing it turns out not to be. Interval cancers are breast cancers that were not detected on screening mammography and are found between mammography screens, prompted by either breast symptoms or additional testing.

"Because of the risk of interval cancers, it's important that women seek medical care for any breast changes or concerns between mammograms," said Dr. Houssami's collaborator Diana Miglioretti, PhD, a senior investigator at Group Health Research Institute. "The good news is that most of the breast cancers detected in survivors between mammography screens were early stage."

Interval-cancer rates were particularly high in women who were younger than 50, had extremely dense breasts, or received breast-conserving treatment (lumpectomy) without radiotherapy for their first cancer. "Our results suggest that we should consider more tailored screening strategies in these women, such as additional or alternate screening modalities in some groups—but this needs further research," Dr. Miglioretti said.

Explore further: US OKs first-ever DNA alternative to Pap smear (Update 2)

More information: JAMA. 2011;305[8]790-799.

Provided by Group Health Research Institute

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Mammogram sensitivity depends on menstrual cycle

Dec 06, 2010

Try to schedule your screening mammogram during the first week of your menstrual cycle. It might make breast cancer screening more accurate for pre-menopausal women who choose to have regular mammograms. This recommendation ...

Recommended for you

US OKs first-ever DNA alternative to Pap smear (Update 2)

9 hours ago

U.S. government health regulators have cleared a genetic test from Roche as a first-choice screening option for cervical cancer. It was a role previously reserved for the Pap smear, the decades-old mainstay of women's health.

New breast cancer imaging method promising

15 hours ago

The new PAMmography method for imaging breast cancer developed by the University of Twente's MIRA research institute and the Medisch Spectrum Twente hospital appears to be a promising new method that could ...

Palliation is rarely a topic in studies on advanced cancer

15 hours ago

End-of-life aspects, the corresponding terminology, and the relevance of palliation in advanced cancer are often not considered in publications on randomized controlled trials (RCTs). This is the result of an analysis by ...

User comments : 0

More news stories

Genetic code of the deadly tsetse fly unraveled

Mining the genome of the disease-transmitting tsetse fly, researchers have revealed the genetic adaptions that allow it to have such unique biology and transmit disease to both humans and animals.