Department of Radiology, Endeavor Health, 2650 Ridge Avenue, Evanston, IL, 60201, USA.
Department of Medicine, Hematology Oncology, Endeavor Health, 2650 Ridge Avenue, Evanston, IL, 60201, USA.
Curr Treat Options Oncol. 2024 Nov;25(11):1451-1460. doi: 10.1007/s11864-024-01271-8. Epub 2024 Oct 28.
Breast cancer does not wait until a woman reaches her 50's to strike. One in six cases occurs in women between the ages of 40 and 49 and breast cancer is the most prevalent cancer and the leading cause of cancer-related deaths among women under 50 in the United States (10% of breast cancer deaths), emphasizing the urgency of early detection (American Society. 2024). Duffy et al. highlight the vital role of mammography screening in younger women, showing that starting screening at 40 reduces breast cancer mortality, with a consistent absolute reduction over time (Duffy et al. Health Technol Assess. 24(55):1-24, 2020). By starting yearly mammograms at 40, we could see a remarkable 40% reduction in breast cancer deaths (Monticciolo et al. J Am Coll Radiol. 18(9):1280-8, 2021). Screening at age 40 also adds little to the burden of overdiagnosis that already arises from screening at age 50 and older. Comparing this to biennial screening between ages 50-74, yearly screening at 40 saves approximately 13,770 more lives annually according to a report by the American Cancer Society published in JAMA in 2015 (Oeffinger et al. JAMA. 314(15):1599-614, 2015). But it's not just about saving lives; it's also about preserving quality of life. Between ages 40 and 49, 12-15% of years of life lost are attributed to breast cancer, highlighting the impact on women's lives. Early detection through screening can minimize these losses, ensuring more years spent with loved ones. It's clear: starting mammograms at age 40 saves lives. We must prioritize early detection and make screening accessible to all women, regardless of age. This proactive approach can reduce the burden of breast cancer and pave the way for a healthier future for women everywhere.
乳腺癌并非等到女性 50 多岁才会侵袭。每六例乳腺癌中就有一例发生在 40 岁至 49 岁的女性中,乳腺癌是美国 50 岁以下女性中最常见的癌症和癌症相关死亡的主要原因(占乳腺癌死亡人数的 10%),这强调了早期检测的紧迫性(美国癌症协会,2024 年)。Duffy 等人强调了在年轻女性中进行乳房 X 线筛查的重要作用,表明从 40 岁开始筛查可以降低乳腺癌死亡率,并且随着时间的推移,死亡率呈持续绝对下降(Duffy 等人,《卫生技术评估》,24(55):1-24,2020 年)。如果我们从 40 岁开始每年进行乳房 X 线筛查,乳腺癌死亡率可显著降低 40%(Monticciolo 等人,《美国放射学会杂志》,18(9):1280-8,2021 年)。与 50 岁及以上开始筛查相比,40 岁开始筛查对过度诊断的负担增加很小。与 50-74 岁期间每两年筛查一次相比,根据美国癌症协会 2015 年在《美国医学会杂志》上发表的报告,40 岁时每年筛查可每年多挽救约 13770 条生命(Oeffinger 等人,《美国医学会杂志》,314(15):1599-614,2015 年)。但这不仅关乎拯救生命,还关乎维护生活质量。在 40 岁至 49 岁之间,12-15%的生命损失归因于乳腺癌,这突出了乳腺癌对女性生活的影响。通过筛查进行早期检测可以最大限度地减少这些损失,确保与亲人共度更多时光。很明显:从 40 岁开始进行乳房 X 线筛查可以挽救生命。我们必须优先考虑早期检测,并使所有女性都能获得筛查,无论年龄大小。这种积极主动的方法可以减轻乳腺癌的负担,为世界各地女性创造更健康的未来。