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There are many reasons women don’t obtain their first mammogram at the recommended age: work commitments and other demands on their time, uncertainty regarding when they should begin screening or about insurance coverage, concerns about the discomfort the procedure can entail, and more.
May Abdo-Matkiwsky, DO, understands all those reasons, but she wants women to understand why it is so important that they prioritize their health and have initial screening at the age recommended for them.
“A large study published last year found that not having that first mammogram at the indicated age is associated with a 40% increase in risk of dying from breast cancer over 25 years,”1 says Dr. Abdo-Matkiwsky, a board-certified medical oncologist who has a practice emphasis on breast cancer. She works with Regional Cancer Care Associates (RCCA), one of the nation’s largest networks of oncology specialists, with more than 20 locations near you across New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area.
The study involved more than 432,000 women in Sweden who were followed for up to 25 years after the age at which a screening program invited them to have their first mammogram, notes Dr. Abdo-Matkiwsky, who practices at RCCA’s Sparta, NJ, offices.
“Over the follow-up period, the rate of new breast cancer cases was 7.8% in women who began screening on time and 7.6% in those who did not, which does not represent a significant difference. However, the rate of death from breast cancer was 40% higher in those who did not receive their first mammogram at the recommended age than in women who started screening on schedule,” explains Dr. Abdo-Matkiwsky.
Niloo Prasad, MD, a board-certified medical oncologist who practices at RCCA’s Edison, NJ offices, adds, “Study participants who did not start screening at the recommended time tended to not have subsequent screenings at the indicated intervals. And among women who later developed breast cancer, those who did not follow the screening schedule were more likely than those who received regular screening to have advanced-stage disease at diagnosis. Specifically, they were 1.5 times more likely to have Stage III cancer, and 3.6 times more likely to have Stage IV cancer. While we have made great strides in managing Stage IV breast cancer, it is the most advanced form of the disease, and our focus at that stage is on prolonging life and preserving quality of life rather than cure.”
Dr. Prasad notes, “The findings from this study, which was published in the British Medical Journal late last year, align with those from another large Swedish study published in the journal Radiology in 2021. In that study, which involved more than 549,000 women, those who had mammograms on the recommended schedule over the course of several years were 49% less likely to die from breast cancer than women who did not follow the screening schedule.”2
The medical oncologist says, “These studies yield a clear message: starting mammography at the recommended age and having follow-up screenings at the intervals recommended by your physician are two of the most important steps a woman can take to protect her health and life.”
Dr. Abdo-Matkiwsky notes that recent breast cancer trends provide further reason to start mammography on schedule. She explains, “More than 70% of cases of breast cancer occur in women aged 55 years and older, with 63 being the median age at diagnosis.3 However, over the past two decades, there has been a steady increase in diagnoses in women younger than 45. The rate of new breast cancer cases in this age group has risen from 27.4 per 100,000 in 2001 to 30.9 per 100,000 in 2022.4 The difference in those rates may seem modest, but it translates into thousands of additional women learning each year that they have breast cancer.”
She adds, “Despite this rising incidence of breast cancer, 38% of women aged 40 to 49 years were not up to date with recommended screening in 2023. By contrast, 79% of women aged 50 to 64 and 82% of those ages 65 to 74 were on schedule.5 I recognize that the forties are ‘prime time’ for having to deal with multiple demands involving work and potentially young children and aging parents, but there’s an analogy to be found in the advice that the flight attendants provide before a plane takes off: First put on your own oxygen mask, then help others. If we want to ‘be there’ for the people and things we care about, we first have to ‘be there’ for ourselves and our own health.”
So, when should a woman begin breast cancer screening?
Dr. Prasad says, “Many of the screening recommendations issued by various organizations have changed in recent years, and there are some subtle differences in those groups’ guidelines in terms of the starting age for screening and screening frequency, which can contribute to women being uncertain about how to proceed.”
The cancer specialist explains, however, that recommendations for women at average risk of developing breast cancer include:
“I want to emphasize that these recommendations are specifically for women considered to be at average risk for breast cancer,” Dr. Prasad says. She adds, “Several factors, including a strong family history of the disease or the presence of a genetic mutation such as BRCA1 or BRCA2, can put a woman at elevated risk, which will affect when she should start screening as well as how and how often screening should be performed. It is important to talk with your primary care provider or Ob/Gyn about the screening schedule that is appropriate for you.”
Dr. Prasad continues, “I realize that having that first mammogram can be a daunting prospect for some women. However, this year, more than 320,000 women across the United States will learn that they have breast cancer, including an estimated 9,510 women here in New Jersey,9 where I practice. The past several years have seen dramatic gains in our ability to treat breast cancer at all stages, and at RCCA we work closely with our surgical and radiation oncology colleagues to provide women with comprehensive care, including offering them the latest in immunotherapy, targeted therapy, hormonal therapy, and clinical trials. Nonetheless, earlier identification and intervention continue to be associated with better treatment outcomes, so I really encourage women to begin screening as soon as they reach the indicated age.”
Dr. Abdo-Matkiwsky adds, “When I meet with patients newly diagnosed with cancer, many are very focused on the why. There’s something deep in our nature that wants to make sense of bad news, to identify a cause-and-effect relationship. In truth, while we understand risk factors at a population level, we generally cannot say definitively what caused a specific person to develop cancer, and even if we could, the focus following diagnosis needs to be on looking forward and on what we can do, not on what perhaps should have been done in the past. So often, however, I hear people say, ‘If only I had done this or hadn’t done that.’ As an oncologist, I’m in the business of hope, not of regret, much less guilt. I don’t want patients to spend their time or energy on those emotions, including by wondering if cancer could have been identified at an earlier stage if they had started screening earlier or had received subsequent screenings on schedule. Making time for yourself by having ‘on time’ screenings is a key step not only for protecting your physical health but also in giving yourself peace of mind now and going forward.”
Dr. Abdo-Matkiwsky and Dr. Prasad are among 90+ medical oncologists and hematologists who practice with Regional Cancer Care Associates (RCCA), one of the nation’s largest networks of oncology specialists. RCCA has more than 20 locations near you across New Jersey, Connecticut, Massachusetts, and the Washington, D.C. area. RCCA’s cancer specialists see more than 30,000 new patients each year and provide care to more than 265,000 established patients, collaborating closely with those patients’ other physicians. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, as well as access to approximately 300 clinical trials. In addition to serving patients who have solid tumors, blood-based cancers, and benign blood disorders, RCCA care centers also provide infusion services to people with a number of non-oncologic conditions—including multiple sclerosis, Crohn’s disease, asthma, iron-deficiency anemia, and rheumatoid arthritis—who take intravenously-administered medications.
To learn more about RCCA, call 844-346-7222 or contact RCCA.
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call 844-346-7222. You can also schedule an appointment by calling the RCCA location nearest you.
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