Should You or Shouldn’t You? New Evidence in the Great Mammogram Debate

Could the radiation from screening actually increase the odds of developing breast cancer among women with a specific gene?
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For the past three years, breast cancer-related organizations and advocates have debated at what age and how often women should receive preventative screenings in the form of mammograms. Despite a United States Preventative Services Task Force report that suggested women benefit most from receiving one mammogram every two years after the age of 50, many have still heralded an annual mammogram after 40 (or even earlier if you have a family history of the disease) as the safest approach.

A new study conducted on approximately 1,800 women in the Netherlands, France, and the United Kingdom, however, suggests that the extra radiation from annual mammograms and other diagnostic testing may actually raise the risk of developing the disease in those with a particular genetic risk.

The study, led by Flora van Leeuwen, head of the Department of Epidemiology at the Netherlands Cancer Institute, examined women who tested positive for a BRCA1/2, a gene variant linked to a five-fold increase in the risk for breast cancer. They found a strong correlation between exposure to diagnostic radiation before the age of 30 with an increased risk of developing the disease. The results, of course, do not provide a causal link between mammograms and breast cancer—but the authors still suggest that young women with BRCA1/2 mutations should be screened using magnetic resonance imaging (MRI) instead.

Several European countries already counsel BRCA1/2+ women to do just that. The United States, to date, does not have any specific guidelines differentiating screenings of BRCA1/2+ women from others—though the American Cancer Society suggests that women with these gene variants receive annual mammograms after age 30. Time will only tell whether these new findings result in the task force making changes to its already controversial guidelines.

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