No Clear Benefit Associated with Breast Cancer Screening for Women with Down Syndrome

Brian Chicoine, MD
Advocate Lutheran General Hospital

The development of health screening guidelines for adults with Down syndrome (DS) requires an understanding of the difference in the incidence of health issues in people with DS. Breast cancer is less common in women with DS. The question is whether mammograms should be included in health screening for women with DS.

What did you do in your research?
We evaluated the results and costs of mammograms in our patients. Records of 683 women (ages 35 and older) and 993 mammograms were reviewed. Data were collected on results of the mammograms, follow-up testing, and outcomes.

What did you find out?
Two women (.7%) were found to have breast cancer, both non-invasive. This low incidence of breast cancer among women with DS is consistent with existing research. After diagnosis, the families of each patient opted not to follow the recommended treatment. Neither woman had a recurrence and both ultimately died of a different condition (Alzheimer disease). The cost per diagnosis of cancer was higher than that reported in the population of women without DS. No clear benefit from the mammograms was found.

What are the take-home messages?
We recommend this information be included for consideration in the process that is presently ongoing to develop health care guidelines for adults with DS. Furthermore, when mammography is considered in the health care guideline development, we recommend eliminating the guideline for screening mammograms for women with DS or at minimum, using the present guideline (for all women) that is most conservative (starting later in life and reduced frequency).

To learn more about these findings contact Dr. Brian Chicoine.

Full Journal Article
Chicoine, B., Roth, M., Chicoine, L., & Sulo, S. (2015). Breast cancer screening for women with Down syndrome: Lessons learned. Intellectual and Developmental Disabilities, 53(2), 91-99.