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| |  Mammography May Increase Breast Cancer Risk in Some High-Risk Women CHICAGO -- December 4, 2009 -- Low-dose radiation from annual mammography screening may increase breast cancer risk in women with genetic or familial predisposition to breast cancer, according to a study presented here on December 1 at the Radiological Society of North America (RSNA) 95th Annual Meeting. “For women at high risk for breast cancer, screening is very important, but a careful approach should be taken when considering mammography for screening young women, particularly under age 30,” said Marijke C. Jansen-van der Weide, PhD, University Medical Center Groningen, Groningen, The Netherlands. “Further, repeated exposure to low-dose radiation should be avoided.” Women who are at high risk for breast cancer need to begin screening at a younger age because they often develop cancer earlier than women at average risk. However, according to Dr. Jansen-van der Weide and colleagues, young women with familial or genetic predisposition to the disease may want to consider alternative screening methods to mammography, because the benefit of early tumour detection in this group of women may be offset by the potential risk of radiation-induced cancer. According to the American Cancer Society (ACS), there is strong evidence supporting the benefits of mammography for women after age 40 years. However, there are conflicting reports regarding the benefits of mammography for women younger than 40 years. Alternative screening methods such as ultrasound and magnetic resonance imaging (MRI) may be made available to younger women, but are generally used as an adjunct to mammography. The ACS recommends that some women at high risk (>20% lifetime risk) should have MR imaging and mammography every year, typically beginning at age 30. The researchers conducted an analysis of peer-reviewed, published medical research to determine if low-dose radiation exposure affects breast cancer risk among high-risk women. Out of 47 articles found on the topic, 6 were selected by the reviewers for inclusion in their analysis. Four studies looked at the effect of exposure to low-dose radiation among breast cancer gene mutation carriers, and 2 studies researched the effect of radiation on women with a family history of breast cancer. Using data from these studies, the researchers were able to calculate pooled odds ratios to estimate radiation-induced breast cancer risk. The results showed that among all high-risk women in the study, average increased risk of breast cancer due to low-dose radiation exposure was 1.5 times greater than that of high-risk women not exposed to low-dose radiation. High-risk women exposed before age 20 or with 5 or more exposures were 2.5 times more likely to develop breast cancer than high-risk women not exposed to low-dose radiation. “Our findings suggest that low-dose radiation increases breast cancer risk among these young high-risk women, and a careful approach is warranted,” Dr. Jansen-van der Weide said. She noted that this analysis is based on a small study sample and should be interpreted with caution. Dr. Jansen-van der Weide also pointed out that these results apply only to specific high-risk groups of women. Women at average risk were not assessed in this study. In general, early detection with mammography and prompt treatment can significantly improve a woman’s chances of survival. More than 90% of women whose breast cancer is found in an early stage will survive. For young, high-risk women and their doctors, it is important to weigh the benefits against any potential risk when making a decision about annual breast cancer screening with mammography.
SOURCE: Radiological Society of North America
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