Screening mammography in women 40 to 49 years of age.

Review content summary This systematic review of 117 studies aimed to determine the risks and benefits of mammography screening for women 40 to 49 years of age. Participants studied were women 40 to 49 years of age. To be included, studies were systematic reviews, randomized-controlled trials, and observational studies. When possible, reviewers focused on evidence from studies featuring specific analyses of women in their 40s. Otherwise, reviewers used studies of screening mammography in older women. Mammography screening interventions were described in this review. Outcomes measured include: overdiagnoses, false positives, pain from mammography procedure, and radiation exposure from mammography procedure. Then the authors considered the individualization (according to age, breast density, family history, etc.) of risks and benefits of mammography screening. Authors report that women 40 to 49 years of age who undergo routine mammography screening will decrease their risk for death (by 7% to 23%) due to breast cancer but will increase their risks for breast cancer–related anxiety, discomfort during screening and exposure to low-dose radiation. Screening mammography is also associated with an increased risk for mastectomy but a decreased risk for adjuvant chemotherapy and hormone therapy. Despite high false-positive rates, the falsepositive results seem to have little effect on psychological health or future mammography adherence. Evidence about the effect of negative screening mammography on psychological well-being or the subsequent clinical presentation of breast cancer is insufficient, and the reviewers recommend that future RCTs focus on these issues..