BREAST CANCER SCREENING IN BRAZIL: IMPACT OF THE AGE AT INITIATION OF MAMMOGRAPHIC SCREENING ON EARLY DETECTION AND CLINICAL OUTCOMES

Abstract

This study aimed to compare the benefits and risks of initiating breast cancer screening at ages 40 or 50, considering early detection, mortality reduction, and potential harms associated with mammography. A systematic literature review was conducted using the PubMed/MEDLINE, LILACS/BVS, and SciELO/Rebrats databases. After applying the eligibility criteria and selecting the studies, 12 articles were included in the analysis. The results indicated that starting screening at age 40 may facilitate early tumor detection and expand opportunities for intervention, particularly among women at higher risk of the disease. However, this strategy may also increase false-positive results, additional examinations, unnecessary biopsies, and overdiagnosis. In contrast, starting screening at age 50 may reduce some of these harms, although the possibility of delayed diagnosis remains for some women. It is concluded that determining the appropriate age to initiate screening should involve balancing benefits and risks, considering individual characteristics and breast cancer risk, as well as recommendations from national and international guidelines.