Women diagnosed with breast cancer who underwent yearly screening mammograms were found to have a lower incidence of advanced-stage cancer and improved overall survival rates compared to those who had screenings every two years or less frequently, according to recent findings.
Recent research from the University of Pittsburgh and UPMC, published in the Journal of Clinical Oncology, indicates that women with breast cancer who had annual mammogram screenings were less likely to be diagnosed with late-stage cancer and had better overall survival rates compared to those screened every other year or less.
According to Dr. Margarita Zuley, the lead author and professor at the University of Pittsburgh’s Department of Radiology, only about 65% of women over the age of 40 undergo breast cancer screenings. Furthermore, only roughly 50% of these women get screened annually, which can be attributed partly to conflicting recommendations regarding screening frequency. “Our research demonstrates a clear advantage for annual screenings compared to screenings every two years, even for premenopausal women,” Zuley pointed out.
While numerous clinical trials have shown the advantages of mammography in breast cancer screening, there is a lack of consensus on how often women should be screened. The American College of Radiology recommends annual screenings starting at age 40, unlike the U.S. Preventive Services Task Force, which advocates for biennial screenings from age 40.
To fill the gap left by the absence of a national breast cancer registry in the U.S., Zuley and her research team created a comprehensive institutional database to analyze the real-world outcomes of breast cancer patients more effectively.
To gather further evidence on the best screening frequencies, the team examined data from 8,145 breast cancer patients who had at least one mammogram before their diagnosis. The screening intervals were classified as annual if the time between mammograms was under 15 months, biennial if it was between 15 and 27 months, and intermittent if it exceeded 27 months.
The rates of late-stage cancers — defined as TNM stage IIB or worse — were found to be 9%, 14%, and 19% for the annual, biennial, and intermittent screening categories, respectively. Those in the biennial and intermittent groups experienced significantly lower overall survival rates compared to the annual screening group.
“As screening intervals increase, the percentage of late-stage cancers rose significantly,” Zuley explained. “Annual mammograms are essential for the early detection of breast cancer, which enhances survival chances, minimizes treatment demands, simplifies recovery, and can lower healthcare costs.”
One challenge with more frequent mammograms is the heightened risk of false positives, which can lead to unnecessary biopsies and emotional distress.
“We acknowledge the potential drawbacks of recalling women for additional screenings; however, I believe these risks do not surpass the dangers of missing cancers and the consequent risk of mortality,” Zuley stated. “We are also exploring screening methods that exhibit fewer false positives than traditional mammography and are striving to optimize cost-effective and precise patient care.”
Additional authors involved in the study included Andriy Bandos, Ph.D., Durwin Logue, Rohit Bhargava, M.D., Priscilla McAuliffe, M.D., Ph.D., Adam Brufsky, M.D., Ph.D., and Robert M. Nishikawa, Ph.D., all affiliated with Pitt and UPMC; along with Stephen Duffy, Ph.D., from Queen Mary University of London.
This research was partially funded by the National Cancer Institute (P30CA047904).
