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Mammograms: For young women, more may not be better


Julie Kapp, assistant professor of family and community medicine at MU

In November, the United States Preventive Services Task Force changed its breast cancer screening recommendations, increasing the starting age for routine mammograms from age 40 to 50. Julie Kapp, assistant professor of family and community medicine at MU, has found that, despite the recommendations, an estimated 29 percent of women younger than age 40 report already having had a mammogram.

“The goal with medicine is to target people for the needs that they have, but not to overscreen them for things that aren’t of concern,” says Kapp, BA, BA ’96, who earned a doctorate in public health from St. Louis University. “With such a rare chance of being diagnosed with breast cancer that early, it is a bit surprising such a large percentage of young women are receiving mammography.”

Before age 40, the risk of developing invasive breast cancer is less than 1 percent, yet Kapp’s research suggests that the majority of first mammograms were for screening purposes, rather than for the evaluation of a breast problem, and only 13 percent of those screened reported a family history.

“One of our concerns is that these women may experience unnecessary negative implications such as false positives and undergo invasive procedures such as biopsies,” Kapp says. “Our next steps are to look at the outcomes of those first mammograms — for example false positives or true negatives — and to see if those outcomes have an impact on patients’ later mammography use based on different racial and ethnic groups.”

Kapp notes that women who have a family history of breast cancer or are at increased risk for breast cancer should talk to their doctors about when to begin mammography. She hopes her research will help health care providers understand how these resources are used for and are impacting younger women.