Almost a third of women younger than 40 without known cancer risk undergo unnecessary mammography screening before breast reduction surgery, according to a research letter published in JAMA Surgery.
More than half a million elective breast surgeries are performed each year in the U.S., and the American Society of Plastic Surgeons has recommended that women undergoing elective breast surgery not receive routine preoperative mammography beyond what existing guidelines recommend for all women. So the concern is that these mammograms among younger women not only boost healthcare costs but also lead to unnecessary interventions, wrote a team led by Dr. Erika Sears of the University of Michigan (JAMA Surg, December 26, 2018).
"Altering screening mammography [protocol] for patients younger than 40 years in the setting of evaluation for breast surgery has a risk for subsequent tests and invasive procedures," Sears said in a statement released by the university.
Sears and colleagues analyzed records of 52,486 women of all ages who were evaluated for breast reduction between 2009 and 2015. They found that nearly one-third of women younger than 40 had the exam before surgery. Of the subset of women in their 30s who had mammograms before breast reduction, 14% went on to have a breast MRI, ultrasound, or biopsy. But cancer was discovered in only 0.5%.
"If there's more awareness among patients, they may be motivated to have a conversation with their doctor about whether screening mammography is right for them," Sears said. "It's also about education on the provider's part about the downstream impact of future testing that women may experience."