Annals of Surgical Oncology

, 18:3137 | Cite as

Potential Impact of USPSTF Recommendations on Early Diagnosis of Breast Cancer

  • Robert Aragon
  • John Morgan
  • Jan H. Wong
  • Sharon LumEmail author
American Society of Breast Surgeons



Current US Preventive Services Task Force (USPSTF) guidelines recommend against routine screening mammography in women aged 40–49 years. However, diagnosis of early-stage breast cancer relies on mammographic screening for detection. We hypothesized that screening at younger age may be important for detecting earlier and more treatable cancers for women in different demographic groups.


All women with ductal carcinoma in situ (DCIS) or T1N0 breast cancer between 2004 and 2008 in the California Cancer Registry were evaluated. Patients were divided into: (1) women aged 40–49 years, who would be excluded from USPSTF recommendations for screening, and (2) women aged 50–74 years, who are recommended for screening. Patients in the two age groups were compared by race/ethnicity, socioeconomic status (SES), and hormone receptor (HR), human epidermal growth factor receptor 2 (HER-2), and triple-negative (TN) status.


Of 46,691 patients identified, 22.6% were aged 40–49 years, and 77.4% were aged 50–74 years. Younger women with DCIS had statistically higher odds of being HR positive and having higher SES, and Hispanic and Asian/Pacific Islander (PI) race/ethnicity, while younger women diagnosed with T1N0 breast cancer had higher odds of being HR positive, HER-2 positive, and triple negative and of having higher SES and non-white race/ethnicity.


Young Hispanic, Asian/PI, and non-Hispanic (NH) Black women in California have greater odds of being diagnosed with early breast cancer than their older counterparts. Excluding 40–49-year-old women from screening could impact early diagnosis of HR-positive, HER-2-positive, and TN tumors. Implementation of USPSTF recommendations could disproportionately impact non-white women and potentially lead to more advanced presentation at diagnosis.


Breast Cancer Breast Cancer Mortality Screen Mammography United States Preventive Service Task Force California Cancer Registry 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported in part by NCI/SEER contracts no. N01-PC-35136, N01-PC-35139, and N02-PC-15105, CDC/National Program for Cancer Registries contract no. U58DP000807- 01, and the California Department of Public Health, Cancer Surveillance Branch.


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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Robert Aragon
    • 1
  • John Morgan
    • 2
    • 3
  • Jan H. Wong
    • 4
  • Sharon Lum
    • 1
    • 3
    Email author
  1. 1.Department of Surgery, Division of Surgical OncologyLoma Linda University School of MedicineLoma LindaUSA
  2. 2.School of Public HealthLoma Linda UniversityLoma LindaUSA
  3. 3.Desert Sierra Cancer Surveillance ProgramLoma Linda University Medical CenterLoma LindaUSA
  4. 4.Department of Surgery, Division of Surgical Oncology, Brody School of MedicineEast Carolina UniversityGreenvilleUSA

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