Mammographic surveillance in women younger than 50 years who have a family history of breast cancer: tumour...

Area of Science:

• Oncology
• Radiology
• Preventive Medicine

Background:

• Mammographic screening reduces breast cancer mortality in the general population.
• The impact of family history on screening effectiveness in younger women remains unclear.

Purpose of the Study:

• To determine if mammographic screening impacts disease stage and projected mortality in women under 50 with a significant family history of breast cancer.

Main Methods:

• The FH01 study enrolled women at intermediate familial risk (under 50) for yearly mammography.
• Comparison groups included the UK Age Trial (general population) and a Dutch study (family history).
• Endpoints included tumor size, node status, grade, and 10-year mortality risk (Nottingham prognostic index).

Main Results:

• Invasive tumors in the FH01 cohort were smaller, less node-positive, and of better grade compared to controls.
• Mean Nottingham prognostic index scores were significantly lower in the FH01 cohort.
• Adjusted 10-year mortality risk was significantly lower in the FH01 cohort (0.80 relative risk).

Conclusions:

• Yearly mammography is effective for women with medium familial breast cancer risk.
• Screening leads to earlier detection and improved survival for high-risk women.