Breast Cancer Archive

Ideally, screening mammography detects small breast cancers so that they can be removed before they grow, metastasize, and kill. To tell whether screening is succeeding, researchers from Harvard and Dartmouth looked at the rates of mammography, the diagnosis of small breast cancers, large breast cancers, and breast cancer deaths in 16 million women 40 or older in the United States from 2000 through 2010. They found that when mammography rates increased 10%, the number of small cancers detected went up 25%, and the number of large cancers increased by 7%. There was no decline in breast cancer deaths. They concluded that mammography is finding—and women are being treated for—small cancers that may not progress to invasive disease or metastasize to other parts of the body.

The results, which were published online July 6, 2015, by JAMA Internal Medicine, echo those of earlier findings. They underscore a dilemma facing women and their doctors: To get annual mammograms and risk being treated for a tumor that may never become harmful, or have mammograms less frequently and risk missing a cancer until it is larger. The U.S. Preventive Services Task force recommends having a mammogram every one to two years for women ages 50 to 79. The American Cancer Society suggests annual mammograms beginning at age 40. You may want to discuss your personal risk profile, and your preferences, with your doctor.

An analysis from the Women's Health Initiative (WHI) suggests not only that postmenopausal women who are overweight or obese have a higher risk of invasive breast cancer than women of normal weight but also that the excess risk increases as a woman's weight rises beyond obesity. The results were published online June 11, 2015, by JAMA Oncology.

A team of investigators from several medical centers studied data on 67,000 postmenopausal women who enrolled in the WHI between 1993 and 1998. They were followed for a median of 13 years. During that time, 3,388 invasive breast cancers were detected. The researchers analyzed the distribution of breast cancer among weight classes and calculated the risks for women who were overweight (body mass index, or BMI, of 25 to 30), obese (BMI 30 to 35), or very obese (BMI over 35) compared with women of normal weight (BMI 25 or less). They found that the increased risk of developing breast cancer ranged from 17% in women who were overweight to 59% in those with a BMI over 35. Among women who began the study at a normal weight, those who gained at least 5% of their original weight had a 12% higher risk of developing breast cancer than those who maintained their original weight. Neither losing weight nor using hormone therapy had a significant effect on risk for women of any weight.

The release of new guidelines on mammography never fails to renew the heated controversy over the potential benefits and harms of this procedure. The latest draft guidelines from the U.S. Preventive Services Task Force (USPSTF) are no exception. The USPSTF recommends that women begin having mammograms at age 50 and stop at age 75. (The American Cancer Society and other medical organizations recommend that women begin getting regular mammograms at age 40.) The draft recommendations say there isn’t enough evidence to recommend or discourage the use of a new technique called 3-D mammography for screening, and also say there isn’t enough evidence to recommend that women with dense breasts, who are at higher risk of breast cancer, should have an ultrasound or MRI in addition to screening mammography. Comments can be made on the USPSTF draft until 8:00 pm Easter Time today. A final version of the recommendations is expected to be released in the fall of 2015.

Although the chance of developing breast cancer increases after age 60, the likelihood of dying from it is low.

If you're like most women, you consider the possibility of learning you have breast cancer every time you have a mammogram. But breast cancer probably doesn't seem as scary as it did when you were younger, because there has been so much good news about breast cancer in the last 20 years—improvements in mammography, advances in surgery and reconstruction, and drugs that are more effective and less toxic.

Although research suggests that women over 70 with early-stage breast cancer can skip radiation treatment, nearly two-thirds of women in that age group continue to receive it, according to findings published online Dec. 2, 2014, by the journal Cancer.

Researchers from Duke University sought to determine whether evidence from a large, randomized clinical trial published in 2004 had influenced treatment for early breast cancer. That study showed that adding radiation therapy to surgery plus tamoxifen does not reduce five-year recurrence rates or prolong survival in older women with early-stage tumors.