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SALT LAKE CITY — New research suggests that most breast cancer deaths occur in younger women who do not receive regular mammograms.
"Mammography is the only imaging test that has been shown in multiple, randomized, clinical, controlled trials to actually save lives," said Dr. Brett Parkinson, medical director at the Intermountain Medical Center Breast Care Center in Murray. "It brings down the death rate."
Since mammography screening was introduced as a detection measure for breast cancer, fewer women have died, according to the study published in the peer-reviewed journal "Cancer."
The study also found that younger women can benefit from routine mammography screening, starting at age 40.
"The biological nature of breast cancer in young women is more aggressive, while breast cancer in older women tends to be more indolent," Dr. Blake Cady, a Harvard professor of surgery and lead author of the study, said in a news release.
Cady said the research suggests that "less frequent screening in older women, but more frequent screening in younger women, may be more biologically based, practical and cost-effective."
The use of mammograms to prevent breast cancer deaths has been controversial, particularly after the United States Preventive Services Task Force proposed in 2009 to limit screening to women ages 50 to 74. Parkinson said that recommendation was based on flawed studies.
"We need to scrutinize the science and ask questions when recommendations are made that fly in the face of clinical experience," he said.
Parkinson and Cady, as well as the American Cancer Society and the American College of Radiology, recommend routine screenings for women starting at age 40.
X-ray mammography and MRI are two methods widely used to detect breast cancer.
Mammograms, although relatively inexpensive, involve minimal radiation exposure and are generally unpleasant. MRI scans are generally used to further examine suspicious areas found by mammograms. Both are beneficial in detecting the potentially deadly disease, but both can produce false positives.
Researchers at BYU and the University of Utah are working on new techniques that have the potential to reduce false positives and possibly decrease the need for unnecessary invasive hospital biopsies. Their study appears in the academic journal "Magnetic Resonance in Medicine."
We need to scrutinize the science and ask questions when recommendations are made that fly in the face of clinical experience.
–Dr. Blake Cady
The group created an MRI device that could improve both the process and accuracy of breast cancer screening by scanning for sodium levels in breast tissue, because sodium concentrations are thought to increase in malignant tumors.
"This method is giving us new physiological information we can't see from other types of images," said BYU electrical engineer Neal Bangerter, who led the research on sodium scans. "We believe this can aid in early breast cancer detection and characterization, while also improving cancer treatment and monitoring."
Unlike other research used to determine screening effectiveness, the Harvard study collected data from breast cancer deaths to discover correlations at the time of diagnosis.
Of the 609 deaths between 1990 and 1999 that were studied, 20 percent were women who had been screened with mammography, while 71 percent were among unscreened women, the study states.
Moreover, 13 percent of the deaths occurred in women age 70 or older, and 50 percent were women under age 50.
The new data "supports the importance of early detection," said study co-author Dr. Daniel Kopans of Harvard Medical School and Massachusetts General Hospital.
