We congratulate the authors of The Lancet mammography screening article proving the beneficial effect of early detection on women in their 40s. Although there is no biologic reason why early detection of breast cancer should not work in women at any age, it has taken a long time to prove this for the younger women in a specifically designed scientific trial. The more rapid growth rate of breast cancer in premenopausal women combined with their higher overall breast density makes screening more challenging in this age group.
To make screening even more effective, the one-year interscreening interval and the use of a multimodality approach (digital mammography combined with automated breast ultrasound) should be used for women of any age with dense breast tissue. The excellent results presented in this article can still be improved by also addressing the problems associated with dense breast tissue in addition to the more rapid tumor growth rate in younger women.