Does Screening Mammography Benefit Women in their 40's?
1. This was an effort to form clinical practice guidelines for the American College of Physicians
2. The data base was English-language articles identified in multiple electronic data bases through 2005.
3. The authors searched for literature on the effects of screening mammography on breast cancer mortality rates and breast cancer treatment.; the risks of screening mammography, including radiation, overdiagnosis, and false-positive results.
4. The initial search revealed 873 full-text articles with 117 articles meeting their standards for relavance and quality.
Results:
A. The meta-analysis revealed a 15% decrease in breast cancer mortality for women in their 40's, who underwent yearly mammography, after 14 years.
B. Previous meta-analyses have found 7 to 23 percent decreases in breast cancer mortality with variations attributed to differences in quality assessment and study inclusion.
C. Indirect evidence, from studies of other radiation sources, suggests that the risk of developing breast cancer from the low-dose radiation exposure during mammography is extremely small.
D. Although studies have documented high rates of false-positive results (20 to 56 percent after 10 mammograms), women with false-positive results were not discouraged from having future screenings and did not suffer permanent psychological effects.
E. Pain and discomfort from mammography varied but did not prevent most women from having future screenings.
F. The authors concluded that an individual risk assessment , taking into account patient factors such as family history and the value attached to a false-positive test result, may be appropriate to guide decisions about breast cancer screening in this group.