Women age 75 years and older should continue to get screening mammograms because of the comparatively high incidence of breast cancer found in this age group, according to a study led by Stamatia Destounis, MD, of Elizabeth Wende Breast Care, LLC, in New York. This research will be presented next week at the annual meeting of the Radiological Society of North America (RSNA).
For the study, researchers analyzed data from 763,256 screening mammography exams, and 10 percent of women included in the study were 75 years of age or older. Overall, screening-detected cancer was diagnosed in 3,944 patients. A total of 616 patients age 75 and older had malignancies for a cancer rate of 8.4 detections per 1,000 exams among this age group.
Guidelines on what age to stop breast cancer screening have been a source of confusion in recent years. In 2009, the United States Preventive Services Task Force (USPSTF) released controversial guidelines stating there was not enough evidence to assess benefits and harms of screening mammography in women age 75 and older. However, other professional groups advise that women may continue to undergo mammography screening as long as they are in good health.
“For the relatively small percentage of our screening population that was comprised of women 75 and older, the patients diagnosed in this population made up 16 percent of all patients diagnosed with screening-detected cancers,” Destounis says.
Researchers also found that 82% of the malignancies diagnosed were invasive cancers, of which 63% were grade 2 or 3, which grow and spread more quickly. Moreover, 98% of the cancers found were able to be treated surgically.
Mammography plays a critical role in the early detection of breast cancer, because it can show changes in the breast up to two years before a woman or her physician can feel them, and early detection leads to better treatment options and improved survival. Destounis advises women over 75 who are in relatively good health to continue routine screenings. “The benefits of screening yearly after age 75 continue to outweigh any minimal risk of additional diagnostic testing,” she says.