A study published in the BMJ in September showed that women who did not have their first mammogram had a higher risk of later developing advanced-stage breast cancer. The result is also 40% higher risk of death by illness.
understand
- Researchers analyzed more than 430,000 Swedish women from 1991 to 2020.
- Several changes were made to the guidelines during this period. Initially, participants were encouraged to have their first mammogram at age 50. However, since 2005, this age has been lowered to 40 years.
- Over 25 years, 16,059 breast cancer cases were recorded.
- Researchers compared cases and deaths to whether participants adhered to recommended guidelines when performing mammograms.
- The results showed that women who chose not to have their first mammogram had a 40% higher risk of dying from breast cancer, a 53% higher risk of being diagnosed with stage 3 disease, and a 260% higher risk of being diagnosed with stage 4 breast cancer.
- Not being screened was also associated with an increased likelihood of missing future breast cancer screening tests.
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What was interesting to scientists was that there was no significant difference in the number of cancer cases between the two groups of women over the 25-year period. The results showed that 7.8% of participants who underwent mammography for the first time were diagnosed with the disease, and 7.6% of participants who postponed the test received the same diagnosis.
Women who didn’t get their first mammogram had a higher risk of later developing advanced-stage breast cancer
Therefore, the data concluded that the group of participants who did not have their first mammogram did not have more cases of breast cancer or more severe cases; rather, their cases were detected at a more advanced stage when they were more lethal.
When is the right time to have a mammogram?
In a conversation with Claudia Meirelles’ columnGynecologist and obstetrician Paula Fetbach, human reproductive expert at FEBRASGO, explains that the most accepted recommendation is for women to have their first mammogram when they turn 40 and repeat the test annually. “This is a standard adopted by the Brazilian Breast Society, the American College of Radiology, and several international medical societies,” he says.
“Mammography is the main test for detecting breast cancer at an early stage, when there are no symptoms and treatment is easier and more effective. Skipping the first mammogram is dangerous, because the test at this very age can identify small lesions before they are palpable or progress,” the expert emphasizes.
Experts say only 5% to 10% of breast cancer cases are linked to genetic factors, such as mutations in the BRCA1 and BRCA2 genes. For most women, this risk is more related to lifestyle and hormonal factors, such as obesity, physical inactivity, alcohol intake, long-term use of hormones, and age at menarche and menopause. “In other words, we need to continue testing even people without a family history, because the majority of cases occur in women with no genetic background,” he said.
The most accepted recommendation is for women to have their first screening mammogram at age 40 and repeat the exam annually.
Paula claims that mammography is a simple and safe test that takes only a few minutes. “You may feel some slight discomfort during breast compressions, but it is completely tolerable,” she believes, adding that no special preparation is required. “Women with very sensitive breasts may prefer to schedule the exam immediately after menstruation, when the tissue is less painful,” he points out.
“Mammography should be performed and monitored by a gynecologist or mammologist who is an expert in breast health. The examination is usually performed by a radiologist trained in breast imaging in a diagnostic clinic or hospital that provides radiology services. It is important to have modern equipment and experienced specialists at the location, which ensures better quality and less discomfort,” emphasizes the doctor.
Now, thanks to advances in early diagnosis, minimally invasive surgery, and new drugs, if cancer is detected early, the chance of curing the disease is over 90%. “It is therefore essential to adhere to mammography from the first examination. The earlier the tumor is identified, the easier the treatment, the more effective breast preservation and the reduced need for chemotherapy. Early detection saves lives, and it all starts with the first examination,” he emphasizes.
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