The potential benefits of mammography for women in their forties include earlier diagnosis and breast -conserving therapy. These benefits must be weighed against the risks or potential risks including discomfort and inconvenience as well as potential risk from mammographic radiation. In addition, the impact of false reassurance given to women with false-negative screens must be considered, given the lower sensitivity of mammography in women in their forties compared with women in their fifties. Professional and public education as well as disclaimers on mammography reports have increased awareness of false-negatives in women with clinical symptoms such as a palpable lump. But mammographic screening of women in this age group must be accompanied by clear information to women and their physicians regarding the need for continued vigilance in regular clinical breast examinations and alertness to new symptoms with prompt evaluation.
More information is needed on the effectiveness of mammography in other racial or ethnic groups.
This consensus statement is a scientific evaluation of the available evidence and does not provide recommendations for public policy or personal action. At the present time, the available data do not warrant a single recommendation for mammography for all women in their forties. Each woman should decide for herself whether to undergo mammography. Given both the importance and complexity of the issues involved in assessing the evidence, a woman should have access to the best possible information in an understandable and usable form. Her health care provider must be equipped with sufficient information to facilitate her decision-making process.