More than 3.5 million women-years of observation have been recorded for women of all ages, and more than 2.7 million women-years for women aged 40 to 49 years at entry from the breast cancer screening RCTs.30 One of the challenging aspects of tracking these trials is the constantly shifting nature of the data.22Thetrialists provide updates at different points in the time, and some reports use non-verified data. Thus, at any given point, review articles may vary substantially in the numbers they report (see Table 22-3). Now, several years later, with most of the international RCTs having more than 10 years of follow-up, trends are clearer: Six of the trials show reduction in mortality for women who where in their 40s at entry. However, a large variability remains in the relative risk of dying from breast cancer for women younger than 50 years. Also, significant controversy surrounds many of the reported numbers.
Although the randomized trials have included too few women older than age 70 years to offer guidance about screening for older women, the Forum on Brest Cancer Screening 37 recommended regular mammograms for women aged 70 years who are otherwise healthy a case-control analysis in the Nijmegen study38 confirmed the benefit of mammography for women older than 70 years.
Seven particularly important published metaanalyses, including the two mentioned earlier, provide assessments regarding the impact of breast cancer screening, especially mammography (Table 22-4). They generally have examined results separately for women aged 40 to 49 years and those aged 50 years and older. (Few women are in the older categories). For women in their 50s and 60s, there is general agreement about the benefits of mammography . The most recent review done by the U.S.Preventive Services Task Force shows a modest benefit for women aged 40 years and older 29. Thus, there is now general consistency in the evidence reviews.
Although the randomized trials have included too few women older than age 70 years to offer guidance about screening for older women, the Forum on Brest Cancer Screening 37 recommended regular mammograms for women aged 70 years who are otherwise healthy a case-control analysis in the Nijmegen study38 confirmed the benefit of mammography for women older than 70 years.
Seven particularly important published metaanalyses, including the two mentioned earlier, provide assessments regarding the impact of breast cancer screening, especially mammography (Table 22-4). They generally have examined results separately for women aged 40 to 49 years and those aged 50 years and older. (Few women are in the older categories). For women in their 50s and 60s, there is general agreement about the benefits of mammography . The most recent review done by the U.S.Preventive Services Task Force shows a modest benefit for women aged 40 years and older 29. Thus, there is now general consistency in the evidence reviews.
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