HYBRID EVENT: You can participate in person at Orlando, USA or Virtually from your home or work.

6th Edition of Nursing World Conference

October 27-29, 2022 | Orlando, USA

October 27 -29, 2022 | Orlando, Florida, USA
NWC 2022

Amy Mu

Speaker at  Nursing World Conference 2022 - Amy Mu
Felician University, United States
Title : Mammogram screening in women aged 40-49 years


Mammogram screening for breast cancer has been a preventive measure in primary care. However, it remains controversial to initiate mammogram in females aged 40-49 years. The main reasons not to screen this group are that people believed that most breast cancers occurred among females older than 50 years of age, and some guidelines, such as U.S. Preventive Services Task Force (USPSTF), stated mammogram screening in women aged 40-49 would be an individual decision. However, since last year, one primary office in north Jersey has found several new cases of breast cancer in women aged 40 years with their first mammograms. All of those cases had none of symptoms, positive finding in breast exams or family history of breast cancer. Some research reviews pointed out that USPSTF weighed much on false positives and over diagnosis of mammograms. However, false positives in groups of aged 40-49 and 50-59 were the same, and over-diagnosis was less than 10% and countered easily. On the other hand, researchers found that USPSTF considered fewer randomized controlled trials (RCTs), less observational studies, and only mortality reduction, compared with the American College of Radiology (ACR) and American Cancer Society (ACS). Recent research reviews supported that annual mammogram in women aged 40 years maxed life years gain and mortality reduction. One review including eight RCTs with meta-analysis showed that mortality of screened women aged 40-49 decreased 15-18%, while some observation studies conducted in four countries for 16-19 years concluded that screening women aged 40-49 years reduced mortality 25-44%. One review found that most breast cancer occurred in age of 45-49 years, not 50-54 years group. Therefore, the ACS recommended starting annual mammogram in women aged 45-49. Research reviews found that unlike USPSTF, both ACS and ACR considered all types of researches. Meanwhile, different from USPSTF and ACS which counted only mortality reduction, the ACR and National Comprehensive Cancer Network (NCCN) considered all established benefits with early detection. On the other hand, different organizations evaluated risks of mammogram differently. Overall, research reviews confirmed that compared with the biennial film screening for females aged 50-74, the annual digital mammogram for women aged 40-49 years saved one third more lives and gained nearly half more life-years. Therefore, the ACR and NCCN recommended starting an annual mammogram at age of 40 years. Based on the clinical experience, researches and guidelines on the mammogram screening in women aged 40s, this PICOT project used the guideline of the ACR and Johns Hopkins Nursing Evidence-Based Model to compare the recommended annual mammogram to the annual breast exam in the primary office in detecting breast cancer in women aged 40-49 years in 14 months. Its purposes are to implement the guideline into a primary office to encourage women in this group to start mammogram annually and detect breast cancer as early as possible. Through this evidence-based practice, APNs will show their important roles in implementing the guideline and making new changes in primary care setting.


Amy studied in Felician University and will graduate as a Master of Science in Nursing – Family Nurse Practitioner this late May. She has worked as a hemodialysis nurse in the chronic and acute units for five years.