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Potential Impact of USPSTF Recommendations on Early Diagnosis of Breast Cancer

  • American Society of Breast Surgeons
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

Current US Preventive Services Task Force (USPSTF) guidelines recommend against routine screening mammography in women aged 40–49 years. However, diagnosis of early-stage breast cancer relies on mammographic screening for detection. We hypothesized that screening at younger age may be important for detecting earlier and more treatable cancers for women in different demographic groups.

Methods

All women with ductal carcinoma in situ (DCIS) or T1N0 breast cancer between 2004 and 2008 in the California Cancer Registry were evaluated. Patients were divided into: (1) women aged 40–49 years, who would be excluded from USPSTF recommendations for screening, and (2) women aged 50–74 years, who are recommended for screening. Patients in the two age groups were compared by race/ethnicity, socioeconomic status (SES), and hormone receptor (HR), human epidermal growth factor receptor 2 (HER-2), and triple-negative (TN) status.

Results

Of 46,691 patients identified, 22.6% were aged 40–49 years, and 77.4% were aged 50–74 years. Younger women with DCIS had statistically higher odds of being HR positive and having higher SES, and Hispanic and Asian/Pacific Islander (PI) race/ethnicity, while younger women diagnosed with T1N0 breast cancer had higher odds of being HR positive, HER-2 positive, and triple negative and of having higher SES and non-white race/ethnicity.

Conclusions

Young Hispanic, Asian/PI, and non-Hispanic (NH) Black women in California have greater odds of being diagnosed with early breast cancer than their older counterparts. Excluding 40–49-year-old women from screening could impact early diagnosis of HR-positive, HER-2-positive, and TN tumors. Implementation of USPSTF recommendations could disproportionately impact non-white women and potentially lead to more advanced presentation at diagnosis.

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Acknowledgment

This study was supported in part by NCI/SEER contracts no. N01-PC-35136, N01-PC-35139, and N02-PC-15105, CDC/National Program for Cancer Registries contract no. U58DP000807- 01, and the California Department of Public Health, Cancer Surveillance Branch.

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, Loma Linda University School of Medicine, Loma Linda, CA, USA

    Robert Aragon MD & Sharon Lum MD

  2. School of Public Health, Loma Linda University, Loma Linda, CA, USA

    John Morgan DrPH

  3. Desert Sierra Cancer Surveillance Program, Loma Linda University Medical Center, Loma Linda, CA, USA

    John Morgan DrPH & Sharon Lum MD

  4. Department of Surgery, Division of Surgical Oncology, Brody School of Medicine, East Carolina University, Greenville, NC, USA

    Jan H. Wong MD

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  1. Robert Aragon MD
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  2. John Morgan DrPH
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  4. Sharon Lum MD
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Correspondence to Sharon Lum MD.

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Aragon, R., Morgan, J., Wong, J.H. et al. Potential Impact of USPSTF Recommendations on Early Diagnosis of Breast Cancer. Ann Surg Oncol 18, 3137–3142 (2011). https://doi.org/10.1245/s10434-011-1915-9

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  • DOI: https://doi.org/10.1245/s10434-011-1915-9

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