Breast cancer is the second leading cause of cancer death among women in the US. Regular mammography screening reduces the number of deaths from breast cancer. Current guidelines recommends that women over the age of 40 undergo a mammography every couple of years. Obesity is an important risk factor for both the development of, and death from, postmenopausal breast cancer.

Researchers from The John Hopkins University School of Medicine in Baltimore, USA, discovered that obese women were putting themselves at greater risk of breast cancer complications by not undergoing regular screenings. They determined that seriously obese women were significantly less likely to have undergone a recent mammography than normal weight women, especially if they were white.

The researchers conducted a systematic review and meta-analysis of 17 studies comprising over 276,000 participants, to look at whether overweight and obese women were less likely to have had a recent mammography than normal weight women. They also looked at the differences in mammography take-up between white and black obese women in three of the studies. They discovered that severely obese women were 20 % less likely to have had a recent mammography. However, this was not the case among black women.

The possible reasons why obese women may not be undergoing breast cancer screening include a delay in taking up medical care because of poor self-esteem and body image, embarrassment, a perceived lack of respect from their health care providers and unwanted weight loss advice.

Authors believe that obesity may be a marker for sub-optimal health behavior in general, of which mammography is simply one element. The authors also point out that there are racial differences in obesity-related body image which may explain the difference in take-up of mammography between white and black women.

They explain some of the increased breast cancer mortality in obese postmenopausal women by lack of routine screening mammography and advise clinicians to be aware of this disparity in evaluating their own practices.