Take Charge

When 30 is the new 40

May 03, 2018

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By Nancy Gay

Women at elevated risk of breast cancer may benefit from earlier and more intensive breast cancer screening with mammograms and MRI, according to new guidelines from the American College of Radiology and the Society of Breast Imaging.

Bethany Niell, MD, associate member of the Diagnostic Imaging and Interventional Radiology Program

The new guidelines, co-authored by Moffitt Cancer Center’s Bethany Niell, MD, recommend that all women be evaluated by age 30 to determine if they are at increased risk for developing breast cancer. Higher-risk women can then reap the benefits of more advanced tests such as earlier screening mammography, and screening breast MRI.

The American College of Radiology continues to recommend that women at average risk begin annual screening mammography at age 40.

Dr. Niell said women in general tend to over-estimate their risk of developing breast cancer. And women at average risk are more likely to over-estimate their risk than high-risk women.

The new guideline recommends women with a strong family history of breast cancer, a greater than 20 percent calculated lifetime risk of breast cancer, or known genetic mutation associated with breast cancer get annual screening mammography beginning at age 30.  Those same women should begin annual screening breast MRI between ages 25 and 30, the guidelines suggest. 

Women who have been treated with chest radiation therapy should begin screening mammography at either age 25 or 8 years after treatment, whichever is later. They should also undergo supplemental screening with MRI. 

For women who have been diagnosed with breast cancer and have dense breasts, or who were diagnosed with breast cancer before age 50, annual breast MRI is recommended in addition to annual mammography.

Screening breast MRI is under-utilized by women with an elevated risk of breast cancer, so Dr. Niell strongly encourages women to advocate for themselves. 

Moffitt routinely performs risk assessment using statistical models endorsed by the American Cancer Society to identify women at an elevated risk of breast cancer who may benefit from supplemental screening in additional to an annual mammography, Dr. Niell said.