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Screening Mammograms Recommended for Women 75 and Over

November 22, 2018

By Lorraine L. Janeczko

NEW YORK (Reuters Health) - Women 75 years of age and above have a higher incidence of breast cancer than younger women and should continue to receive screening mammograms, according to U.S. researchers.

"Our study results confirm that this population of women has the highest cancer-detection rate, which is substantially higher than rates in other age groups," said Dr. Stamatia Destounis of the University of Rochester Medical Center in Rochester, New York.

"The benefits of annual screening after age 75 continue to outweigh any minimal risk that may arise from additional diagnostic testing," she told Reuters Health by email. "The size of the tumors identified with screening mammography in our study was small, with a low percentage of lymph node metastases and overall good prognostic indicators."

The findings will be presented November 25 at the 2018 annual meeting of the Radiological Society of North America.

Dr. Destounis and colleagues reviewed records of more than 763,000 screening mammograms performed between 2007 and 2017 at one academic center. They excluded cases of non-breast malignancies, breast cancer diagnosed by a method other than mammography, and those with missing or incomplete records.

Ten percent of the mammograms were in women 75 years of age or above (mean age, 80.4 years), yet this group accounted for 16% of all screen-detected cancers and had a high cancer-detection rate (8.4 per 1,000 screenings).

A total of 645 malignancies were diagnosed in 616 patients 75 and older. Most cancers were low stage (79%) and node negative (92.5%).

Overall, 82% of the older women's cancers were invasive, and 98% had breast cancer surgery.

Positive lymph nodes were reported at surgical excision in 7% of patients. Due to advanced patient age or overall decline in health, 17 cancers were not treated with surgery.

These findings suggest that most women 75 and over are in good health and want to pursue surgical excision, Dr. Destounis notes in her presentation, which she shared with Reuters Health.

Given their increased incidence of breast cancer, women in this age group should continue to receive screening mammograms, she feels. The current average life expectancy for women in the U.S. is 81.30 years, with around 25% of today's 65-year-olds projected to live past 90 and 10% beyond 95.

Dr. Gary J. Whitman, a professor of radiology and radiation oncology at the University of Texas MD Anderson Cancer Center in Houston, told Reuters Health by email, "This paper supports screening mammography for women greater than 75 years old."

"I am not surprised by the results, as the greatest risk factors for developing breast cancer are being a woman and increasing age," added Dr. Whitman, who was not involved in the study.

Dr. Destounis noted, "The recommendations for breast cancer screening for women 75 and over are not transparent and in fact conflict with some health care organizations and societies."

"The decision of whether to continue with breast cancer screening detection and mammography should be an individual one based on woman's overall health," Dr. Destounis advised.

Funding information was not provided.


RSNA 2018.

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