Abstract

Breast cancer among women aged 40 to 49 is of major importance, because about 25% of all deaths from breast cancer among women of all age groups occur in women who had their breast cancer diagnosed when they were in their 40s. Although mortality reduction through screening has been proved in randomized trials for women aged 50 and older, no single randomized trial has been adequately designed to specifically evaluate women aged 40 to 49. Results from seven randomized trials and follow-up studies that were not randomized support annual screening of all women aged 40 to 49 by mammography, physical examination, and monthly breast self-examination. If such screening were performed with current state-of-the-art mammography, as opposed to the older mammographic techniques used in the trials, it is likely that mortality reduction would be substantially greater than that found in those trials.