In Reply We agree with Dr Lannin that the evidence of the benefits of mammography in women at higher risk for breast cancer is limited. None of the randomized trials of mammography screening specifically assessed if the mortality benefits of mammography differed for higher-risk groups, such as women with a family history of breast cancer or women with dense breasts, compared with women at lower risk. However, these trials did allow assessment of the modifying effect of age, one of the most important risk factors for breast cancer. Results from meta-analyses suggest that the relative risk reduction is greater for 60- to 70-year-old women than for younger women, as shown in Table 1 of the article.
Pace LE, Keating NL. Risk and Benefits of Screening Mammography—Reply. JAMA. 2014;312(6):649–650. doi:10.1001/jama.2014.7664
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