Mammography screening effectiveness in women in their 40s is reduced because tumors are harder to find, not because they grow faster, according to a study published Tuesday in The Journal of the National Cancer Institute.

Tumors in younger women tend to grow more quickly, and because younger women have denser breasts, detection is much harder.

The goal of this research, explained lead researcher Dr. Sylvia Plevritis, was to compare biology and technology to discover which was the major driver in the lower performance of mammography screening in young women.
Researchers, led by Plevritis of the Stanford University School of Medicine, used a computer-simulated model to estimate the relative effect of biology and technology on mammogram screening of women in their 40s compared to women in their 50s and 60s.

The researchers studied simulations that showed scenarios in which younger women had the technological characteristic -- better detectability -- of older women and their normal biological characteristic -- rate of tumor growth -- which can't be changed. The result? This simulation showed that lowered mammographic tumor detectability accounted for 79 percent of the poorer sensitivity in mammography screening, while faster tumor volume doubling time (tumor growth) accounted for only 21 percent of poorer sensitivity.

"We feel [better technology] could make a big difference in detection rate," Plevritis told DOTmed News. "If you improve the technology it will make up for the difference in performance of the detection rate."

The findings further implicate that breast density is something researchers need to study further, said Diana Rowden, vice president of survivorship and outcomes for Susan G. Komen for the Cure.

"We have to better understand what connection between breast density and the risk of breast cancer there is," she told DOTmed News. "It points to [the fact that] mammography is not a perfect tool."

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