Too Many Women Not Getting Mammograms

A disturbing study from researchers at the Massachusetts General Hospital in Boston has found that most women do not follow the minimum American Cancer Society recommendations for receiving a yearly screening mammogram beginning at age 40.

The researchers, led by Dr. James Michaelson, collected data on 59,899 women who received 196,891 mammograms at the Massachusetts General Hospital Breast Imaging Division from January 1, 1990 to March 1, 1999. Eventually, 810 women were found to have invasive breast tumors during the study period.

Writing in the journal Cancer, the researchers noted that while 25 percent of these tumors were found in women in their 40s, more than half of the women in the study group waited to have their first mammogram until after age 50.

Also, approximately 25% of the invasive breast tumors found during the study were in women for whom there was no record of a previous screening mammogram-thus underscoring the importance of getting initially screened at an early age.

Alarmingly, few women in the study returned promptly for a follow-up annual exam; after 18 months, only 50 percent had a subsequent mammogram. For those women in whom a tumor was eventually detected, it tended to be larger and more difficult to treat because of the delay in follow-up screening.

"Most tumors probably emerged as larger, palpable masses not because they were missed at the previous negative mammogram, because most were too small then to have been detected, but because too much time had been allowed to pass," they wrote.

"Far too many women did not comply with the American Cancer Society recommendation of prompt annual screening from the age of 40 years," they warned. "Consequently, almost 50% of the invasive tumors emerged as larger and, thus, potentially more lethal, palpable masses."

"These disappointing findings probably underestimate the national failure to utilize breast cancer screening to its fullest benefit," they added. "The data presented here suggest that prompt annual screening would have provided a substantial reduction in the sizes of the many tumors found among the patients."

SOURCE:
Cancer, January 1, 2002; 94:37-43

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