Tipping the Balance of Benefits and Harms to Favor Screening Mammography Starting at Age 40 Years
Authors: Nicolien T. van Ravesteyn, Diana L. Miglioretti, Jeanne S. Mandleblatt
Journal: Annals of Internal Medicine (2012)

Letters16 October 2012Tipping the Balance of Benefits and Harms to Favor Screening Mammography Starting at Age 40 YearsNicolien T. van Ravesteyn, MSc, Diana L. Miglioretti, PhD, and Jeanne S. Mandleblatt, MD, MPHNicolien T. van Ravesteyn, MScFrom Erasmus Medical Center, 3000 CA Rotterdam, the Netherlands; Group Health Research Institute, Seattle, WA 98101; and Lombardi Comprehensive Cancer Center, Washington, DC 20007.Search for more papers by this author, Diana L. Miglioretti, PhDFrom Erasmus Medical Center, 3000 CA Rotterdam, the Netherlands; Group Health Research Institute, Seattle, WA 98101; and Lombardi Comprehensive Cancer Center, Washington, DC 20007.Search for more papers by this author, and Jeanne S. Mandleblatt, MD, MPHFrom Erasmus Medical Center, 3000 CA Rotterdam, the Netherlands; Group Health Research Institute, Seattle, WA 98101; and Lombardi Comprehensive Cancer Center, Washington, DC 20007.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-8-201210160-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Ms. Wu and colleagues for their comments and estimate of the number of women in their 40s who might consider mammography on the basis of risk. Their estimate is higher than that suggested by our models combined with the review of risk factors in this age group (1). We found that women with a 2-fold increased risk can expect the same harm–benefit ratio from biennial screening in their 40s as average-risk women starting at age 50 years. This level is found among women aged 40 to 49 years with a first-degree relative with breast cancer (9%), ...References1. Nelson HD, Zakher B, Cantor A, Fu R, Griffin J, O'Meara ES, et al. Risk factors for breast cancer for women aged 40 to 49 years: a systematic review and meta-analysis. Ann Intern Med. 2012;156:635-48. [PMID: 22547473] LinkGoogle Scholar2. Carney PA, Miglioretti DL, Yankaskas BC, Kerlikowske K, Rosenberg R, Rutter CM, et al. Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammography. Ann Intern Med. 2003;138:168-75. [PMID: 12558355] LinkGoogle Scholar3. Elmore JG, Carney PA, Abraham LA, Barlow WE, Egger JR, Fosse JS, et al. The association between obesity and screening mammography accuracy. Arch Intern Med. 2004;164:1140-7. [PMID: 15159273] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Nicolien T. van Ravesteyn, MSc; Diana L. Miglioretti, PhD; Jeanne S. Mandleblatt, MD, MPHAffiliations: From Erasmus Medical Center, 3000 CA Rotterdam, the Netherlands; Group Health Research Institute, Seattle, WA 98101; and Lombardi Comprehensive Cancer Center, Washington, DC 20007.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2358. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTipping the Balance of Benefits and Harms to Favor Screening Mammography Starting at Age 40 Years Nicolien T. van Ravesteyn , Diana L. Miglioretti , Natasha K. Stout , Sandra J. Lee , Clyde B. Schechter , Diana S.M. Buist , Hui Huang , Eveline A.M. Heijnsdijk , Amy Trentham-Dietz , Oguzhan Alagoz , Aimee M. Near , Karla Kerlikowske , Heidi D. Nelson , Jeanne S. Mandelblatt , and Harry J. de Koning Risk Factors for Breast Cancer for Women Aged 40 to 49 Years Heidi D. Nelson , Bernadette Zakher , Amy Cantor , Rongwei Fu , Jessica Griffin , Ellen S. O'Meara , Diana S.M. Buist , Karla Kerlikowske , Nicolien T. van Ravesteyn , Amy Trentham-Dietz , Jeanne S. Mandelblatt , and Diana L. Miglioretti Tipping the Balance of Benefits and Harms to Favor Screening Mammography Starting at Age 40 Years Lindsey C. Wu , Barry I. Grabaud , and Mitchell H. Gail Metrics Cited byRisk Prediction for Breast, Endometrial, and Ovarian Cancer in White Women Aged 50 y or Older: Derivation and Validation from Population-Based Cohort StudiesHow Do I Screen Patients for Breast Cancer?Mammography Screening for Breast Cancer 16 October 2012Volume 157, Issue 8Page: 597-598KeywordsAge groupsBreast cancerConflicts of interestDecision makingDisclosureMammographyMedical risk factorsSpecificity ePublished: 16 October 2012 Issue Published: 16 October 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...