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Technology May Explain Mammogram's Poorer Performance in Younger Women
Date:7/28/2010

By Kathleen Doheny
HealthDay Reporter

TUESDAY, July 27 (HealthDay News) -- The poorer tumor detection rate offered by mammography for women in their 40s is due more to the technology itself than characteristics of a younger woman's cancer, according to a new study.

For years, experts have known that mammography's performance is poorer for women in their 40s versus older women, and they've placed much of the blame on the notion that tumors typically grow faster in younger women.

That would mean that by the time they are at a size detectable by mammogram, these tumors would have already been detected by a routine clinical exam, anyway. Younger women's breast tissue is also denser, which can make it easier for tumors to ''hide" on a mammogram.

But others have suspected that mammography's poorer performance among younger women is due more to the limits of the technology.

The issue is particularly pressing since experts at the U.S. Preventive Services Task Force updated their breast cancer screening guidelines last November. Those guidelines advised that normal-risk women in their 40s no longer get a yearly mammogram. The decision set off a firestorm of controversy that has not yet abated.

In the meantime, why are mammograms less apt to spot disease in younger women?

"I set out to find out -- is it the difference in [women's] biology or technology?" said Sylvia Plevritis, associate professor of radiology at the Stanford University School of Medicine, Stanford, Calif.

With her colleagues, she developed a breast cancer screening simulator, a computer simulation model that could estimate the relative contributions of factors such as tumor growth versus tumor detectability on a mammogram.

Plevritis drew on data for about 100,000 women from the SEER database (Surveillance, Epidemiology and End Results), a widely used source of health information. Her team looked at women aged 40 to 49 and w
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