Risk-Based Mammography Recommendations May Miss Some Breast Cancers

Elissa R. Price, MD Assistant Professor of Clinical Radiology Director of Clinical Operations, Breast Imaging Breast Imaging Fellowship Program Director Department of Radiology and Biomedical Imaging University of California, San Francisco San Francisco, CA  94115MedicalResearch.com Interview with:
Elissa R. Price, MD
Assistant Professor of Clinical Radiology
Director of Clinical Operations, Breast Imaging
Breast Imaging Fellowship Program Director
Department of Radiology and Biomedical Imaging
University of California, San Francisco San Francisco, CA  94115

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Price: Screening mammography recommendations for the 40 – 49 age group is very controversial. 2009 USPTF guidelines emphasized taking patient context into account when making decisions for these young women. Recent publications have suggested risk-based screening strategies.  Family history and breast density are important are easily accessible risk factors.

Had we been using this risk-based approach to screening mammography at our institution, we would have missed more than 3Ž4 of the screen detected breast cancers in the 40-49 age group, thereby foregoing most of the survival benefit from screening mammography.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Price: It is not appropriate to base screening decisions on strong family history and extremely dense breast tissue alone. These risk factors do not discriminate which of these young women will develop breast cancer.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Price: For proponents of risk-based screening, we urge them to continue research to find more effective means of risk-based triage, as our data demonstrates that breast density and family history alone are not sufficient.

Citation:

2014 RSNA abstract discussing:

Risk-based Screening Misses Breast Cancers in Women in Their Forties