In 2009, the U.S. Preventive Services Task Force, an independent panel of medical experts, issued recommendations that women 50 to 74 have mammograms every two years. But since comorbid illnesses may reduce the benefit of screening mammography for women 65 and older, there is ambiguity in the medical imaging community regarding appropriate breast screening intervals.
In order to gain clarity on this issue, Dejana Braithwaite, PhD, of the University of California, with a team of researchers, conducted a study that compared annual with biennial screening mammography and the effect on whether the cancer was diagnosed at a late stage. In addition, researchers compared how the two intervals affected the number of false-positive test results. The study was published February 5, 2013 in the online Journal of the National Cancer Institute.
Data on 140,000 Women
The researchers looked at data, collected from 1999 to 2006, that included 2,993 older women with breast cancer and 137,949 without breast cancer, ages 66 to 89. The women all had mammograms at facilities that participated in a data linkage between the Breast Cancer Surveillance Consortium and Medicare claims.
The study concluded that women aged 66 to 89 years who undergo biennial screening mammography have similar risk of advanced-stage disease and lower cumulative risk of a false-positive recommendation than annual screeners, regardless of comorbidity.
Variations in False Positives
While the breast cancer levels were not affected by screening interval, the research findings did find variations in false positive results. For women between the ages of 66 and 74, who were screened annually, 48 percent had false positive results. But for those women in the same age range, who had biennial screening, 29 percent had false positives.
“As is the case in younger women, most older women who undergo annual mammography are at high risk of false-positive mammography results and biopsy recommendations without added benefit from more frequent screening,” wrote Braithwaite.
While the recommendation for more quantitative mammography screenings may be noble, it ultimately falls on more qualitative screenings to significantly impact false positive results. New technology, including 3D digital mammography, is just one step in bringing these qualitative screenings to reality – and in so doing – creating an even more noble atmosphere of patient care.
What has been your organization’s strategy in reducing false positives in mammography screenings – and how do you see new technology helping to further reduce this risk? I encourage you to share your feedback via a comment below.
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