Mammography for Women in Their 40s: Moving Toward Risk-Based Screening

Screening mammography for women in their 40s remains controversial (JW Womens Health Feb 4 2010). Because prevalence of breast cancer is lower and mammograms are more difficult to interpret in women of this age range, the benefits of routine screening (e.g., breast cancer deaths averted) are attenuated compared with those in older women and the potential for harm (false-positive results resulting in unnecessary biopsies) is greater.

Now, results of a meta-analysis and an accompanying modeling study suggest that mammography screening is appropriate in certain higher-risk women in their 40s. Having mammographically dense breasts or a first-degree relative with a history of breast cancer was associated with a doubling of risk for this malignanc…