Are mammograms helpful for older women?

Then there is the data from an analysis of 763,256 mammographic screenings performed between 2007 and 2017 that revealed cancer in 3,944 women, 10% of whom were 75 years and older. Study author Dr Stamatia Destounis, radiologist at Elizabeth Wende Breast Care in Rochester, NY, reported that most cancers in older women were invasive and of a grade that should be treated. Almost two-thirds had the potential to spread and grow rapidly.

Dr Destounis told Healthline: “Annual screening after age 75 has advantages. Mammography continues to detect invasive cancers in this population that are both nodal and low, allowing these women to undergo less invasive treatment. The age to stop screening should be based on each woman’s health status, not on her age. “

At the same time, women are living longer and spending more of those extra years in a fairly healthy and productive way. For them, said Dr Destounis, finding early invasive cancers that can be treated with minimal surgery and postoperative therapy can mean a lot to patients, their families and their communities.

Yet there is one fact that all older women should know: according to Diana Miglioretti, biostatistician at the University of California, Davis, “There is no evidence from randomized controlled trials on whether the Screening women aged 75 or older reduces breast cancer mortality. Evidence suggests that the benefits of screening don’t show up until 10 years later. She said there’s also a risk of overdiagnosis that increases with age – finding cancer that wouldn’t have harmed the woman in your life.

In an interview, Dr. Mara A. Schonberg, an internist at Beth Israel Deaconess Medical Center in Boston, echoed Dr. Miglioretti’s concerns. “Over-detection in older women is a problem, and even finding breast cancer is not always a good thing. It takes at least 10 years of screening 1,000 women aged 50 to 74 to prevent death from breast cancer, and probably even longer in women over 75 in whom breast cancer tends to be more indolent . It is not certain that all of the aggressive treatment that older women receive is necessary.

Additionally, among 1,000 women aged 75 to 84 who continue to have mammograms for five years, 100 will receive false alarms, creating anxiety and causing a series of tests that do not detect cancer. With the mammogram continuing, within five years, three in 1,000 older women will die of breast cancer, compared to four women who do not have a mammogram, Dr. Schonberg reported. She also noted that among women aged 75 to 84 who die in the next five years, 12 times more will die from heart disease than from breast cancer.

To help women decide whether it is in their best interests to continue having regular mammograms after age 75, Dr Schonberg and colleagues have designed a decision aid, available in English and Spanish.