Benign-Appearing Mammographic Abnormalities in Women Aged 40-49

The ongoing debate was addressed concerning the appropriateness of mammographic screening for women aged 40–49 years, with particular emphasis on those patients with benign‐appearing mammographic abnormalities (BMA), and whether findings differed from those of successive age decades. A review was conducted of 2,482 patients presenting for surgical consultation with a mammographic abnormality as a chief complaint, with particular emphasis on the 1,632 patients with BMA and more specifically those aged 40–49 years. Surgical interventions and risk factors for breast cancer were evaluated. Although 16% of 393 patients with BMAs biopsied were proven to have breast cancer, only 2.7% of all patients with BMAs were found to have breast cancer as a result of biopsy or short‐term follow‐up. Women aged 40–49 years represented 48% of patients with BMAs, and only 1.5% of these patients had breast cancer. The finding of breast cancer in the BMA population was progressive by decade of age, as would be expected, and in a cut‐point analysis of those biopsied, age 60 best divided patients into high‐ and low‐risk groups. Women aged 40–49 years with BMAs should not be excluded from mammographic screening, as they represented part of a continuum when successive decades were compared. Efforts should be directed at minimizing patient and physician anxieties as well as diagnostic interventions related to a BMAs.