There is no decrease in the number of breast cancer deaths if screening mammography is performed in women aged <40 years. However, NCCN guidelines recommend screening mammography in young women at risk of hereditary breast cancer. Therefore, more accurate screening mammography for young women is needed.

To evaluate the features of screening mammographic findings, particularly microcalcifications, in women aged <50 years to increase the positive predictive value of screening mammography in young women.

The researchers retrospectively reviewed the data of consecutive women who underwent opportunistic and organized breast cancer screening at the Sakuragaoka Hospital (Shizuoka, Japan) between April 2013 and March 2015. They compared the mammographic findings and features of microcalcifications between women aged <40 and 40–49 years and those aged 50–74 years.

Microcalcifications

The study included 3645 women. Of these 3645 women, 415 (11.4%) were aged <40 years, 1219 (33.4%) were aged 40–49 years and 2011 (55.2%) were aged 50–74 years.

Women aged <50 years were more likely to be recalled for microcalcifications than those aged 50–74 years (<40 years, 4.8%; 40–49 years, 4.3%; 50–74 years, 3.3%).

Young women were more likely to be recalled for small round and segmental microcalcifications [<40 years, odds ratio (OR): 1.799 (95% CI: 0.751–2.846); 40–49 years, OR: 1.394 (95% CI: 0.714–2.074)] and less likely to be recalled for small round and grouped microcalcifications [<40 years, OR: 0.603 (95% CI: 0.181–1.025); 40–49 years, OR: 0.961 (95% CI: 0.496–1.428)] compared with women aged 50–74 years.

On screening mammography, women aged <50 years had a higher tendency to be recalled for microcalcifications, particularly small round and segmental microcalcifications. False-positive results may be reduced by reflecting the characteristics of microcalcification findings among young women without breast cancer in the future.