Table 4. Estimated Impact of Starting Mammography at Earlier Ages for Strategies With MRI Screening Starting at Age 30 Years in Modeled Women With ATM, CHEK2, and PALB2 Pathogenic Variants.
| Start age | Breast cancer mortality reduction, mean (range), %a | Life-years gained, mean (range)a | False-positive screenings, mean (range)a,b | Benign biopsies, mean (range)a,b | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ATM | CHEK2 | PALB2 | ATM | CHEK2 | PALB2 | ATM | CHEK2 | PALB2 | ATM | CHEK2 | PALB2 | |
| MRI at 30 y, annual mammography at 40 y vs no screening | 59.5 (58.5-60.4) | 58.4 (57.2-59.6) | 55.4 (55.3-55.4) | 501 (478-523) | 620 (587-652) | 1025 (998-1051) | 5415 (5437-5393) | 5284 (5249-5319) | 5075 (5057-5093) | 1528 (1517-1538) | 1493 (1479-1508) | 1439 (1429-1449) |
| MRI at 30 y, annual mammography at 35 vs 40 y | 0.2 (0.1-0.2) | 0.1 (0.1-0.2) | 0.1 (0.1-0.1) | 2 (2-2) | 3 (2-3) | 3 (3-3) | 338 (291-386) | 339 (291-387) | 338 (291-385) | 37 (20-55) | 38 (20-55) | 37 (20-55) |
| MRI at 30 y, annual mammography at 30 vs 40 y | 0.3 (0.2-0.3) | 0.2 (0.1-0.2) | 0.1 (0.1-0.2) | 3 (3-4) | 4 (4-5) | 5 (5-5) | 650 (603-696) | 650 (603-696) | 649 (602-695) | 59 (41-76) | 59 (41-76) | 58 (41-76) |
Abbreviation: MRI, magnetic resonance imaging.
a
Results are shown as model mean values of cumulative lifetime outcomes per 1000 women screened across Model E (Erasmus Medical Center, Rotterdam, the Netherlands) and Model W-H (University of Wisconsin–Madison, Madison; Harvard Medical School, Boston, Massachusetts).
b
Total false-positive screenings and benign biopsies exceed the number of women screened because women can experience multiple false-positive screenings and/or benign biopsies during their lifetimes.