Group of radiologists push for ‘assessment’ of breast cancer risk before age 25

By Cara Murez HealthDay Reporter

THURSDAY, May 4, 2023 (HealthDay News) — While the typical recommendation is that women begin having mammograms at age 40, the American College of Radiology has released new guidelines that require all women to have an evaluation of breast cancer risk by age 25 to determine whether they should start having screening mammograms before they turn 40.

“The latest scientific evidence continues to point to earlier assessment, as well as increased screening and before the age of 40 of many women – especially black women and other minority women,” said the corresponding author of the guidelines. Dr. Debra Monticciolodivision chief of breast imaging at Massachusetts General Hospital in Boston.

“These evidence-based updates should spur more informed doctor-patient conversations and help providers save more lives,” she said in an ACR press release.

The ACR also recommended that women who were diagnosed with breast cancer before age 50 and those with a personal history of breast cancer and dense breasts have an additional breast MRI every year. Those who cannot have an MRI should have contrast-enhanced mammography (CEM) instead.

For women at average risk, the ACR recommends continuing annual screening beginning at age 40.

The breast cancer death rate in the United States has dropped 43% since mammography became widespread in the 1980s, according to data from the US National Cancer Institute Surveillance, Epidemiology, and End Results (SEER). The rate had not changed in the previous 50 years. Breast cancer rates, meanwhile, have not changed for men, who undergo the same treatment as women but without regular screening.

Reasons for black and other minority women to get screened earlier include the fact that before the age of 50, minority women are 127% more likely to die of breast cancer than white women. They are also 72% more likely to be diagnosed with breast cancer and 58% more likely to be diagnosed with advanced breast cancer.

Even with roughly equal incidence rates, black women are still 42% more likely to die from breast cancer, less likely to be diagnosed at stage 1 but still twice as likely to die from a early breast cancer.

Black women also have a twice as high risk of aggressive breast tumors – “triple negatives” – and a higher risk of BRCA1 and BRCA2 genetic mutations.

“Since 1990, breast cancer death rates among black women, who develop and die earlier from the disease, have declined only about half as fast as among white women,” the co said. – author of the guidelines. Dr. Stamatia DestounisChairman of the American College of Radiology Breast Imaging Commission and Managing Partner at Elizabeth Wende Breast Care in Rochester, NY

“We continue to regularly review the latest evidence and update our recommendations to help save more black women and other high-risk people from this deadly disease,” Destounis said in the statement.

SOURCE: American College of Radiology, press release, May 3, 2023

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