Updates in Breast Cancer Screening and Diagnosis.

Opinion statement: Breast cancer does not wait until a woman reaches her 50's to strike. One in six cases occurs in women between the ages of 40 and 49 and breast cancer is the most prevalent cancer and the leading cause of cancer-related deaths among women under 50 in the United States (10% of breast cancer deaths), emphasizing the urgency of early detection (American Society. 2024). Duffy et al. highlight the vital role of mammography screening in younger women, showing that starting screening at 40 reduces breast cancer mortality, with a consistent absolute reduction over time (Duffy et al. Health Technol Assess. 24(55):1-24, 2020). By starting yearly mammograms at 40, we could see a remarkable 40% reduction in breast cancer deaths (Monticciolo et al. J Am Coll Radiol. 18(9):1280-8, 2021). Screening at age 40 also adds little to the burden of overdiagnosis that already arises from screening at age 50 and older. Comparing this to biennial screening between ages 50-74, yearly screening at 40 saves approximately 13,770 more lives annually according to a report by the American Cancer Society published in JAMA in 2015 (Oeffinger et al. JAMA. 314(15):1599-614, 2015). But it's not just about saving lives; it's also about preserving quality of life. Between ages 40 and 49, 12-15% of years of life lost are attributed to breast cancer, highlighting the impact on women's lives. Early detection through screening can minimize these losses, ensuring more years spent with loved ones. It's clear: starting mammograms at age 40 saves lives. We must prioritize early detection and make screening accessible to all women, regardless of age. This proactive approach can reduce the burden of breast cancer and pave the way for a healthier future for women everywhere.