THE COMPARATIVE VALUE OF MAMMOGRAPHIC SCREENING FOR WOMEN 40-49 YEARSOLD VERSUS WOMEN 50-64 YEARS OLD

OBJECTIVE. The purpose of our study was to compare the major prognosti c factors (tumor size, axillary lymph node status, and tumor stage) of breast cancers detected at mammographic screening in women ages 40-49 years old with those in women ages 50-64 years old. MATERIALS AND MET HODS, Study subjects were women ages 40-64 years old who participated in our mobile van mammographic screening program from April 1985 to Ju ne 1994, We retrospectively reviewed the clinical and pathology record s of women in whom breast cancer was detected at mammographic screenin g, All examinations were performed with dedicated equipment using scre en-film technique, RESULTS, A total of 44,301 screening examinations w ere done during the study period, Seventy-five cancers were detected i n women ages 40-49 years old, and 128 cancers were detected in women a ges 50-64 years old, The cancer detection rate was 3.0 per 1000 examin ations in the younger age group compared with 5.5 per 1000 examination s in the older age group. The median size of breast cancers was 10 mm for women ages 40-49 versus 11 mm for women ages 50-64, Eighty-eight p ercent of the patients in both age groups had no evidence of metastasi s to axillary lymph nodes, Nineteen percent of women in the younger ag e group had advanced breast cancer (stage II or higher) compared with 26% of women ages 50-64 (p=.25), No statistically significant differen ces were noted between the two age groups in the size, lymph node stat us, or stage of breast cancers detected at mammographic screening. How ever, the cancers found in younger women had slightly more favorable p rognoses, CONCLUSION, The major prognostic factors of cancers detected with modern mammographic equipment appear to be at least as favorable for women ages 40-49 years old as for women ages 50-64 years old, As mammographic screening has already been shown to be beneficial for wom en ages 50-64 years old, screening should also be beneficial for women ages 40-49 years old.