Screening Guidelines And Ageism

Most of the controversy surrounding mammography involves when to start screening - 35? 40? 50? However, the US Preventative Services Task Force has also suggested that the evidence for continued screening after age 75 is lacking. Now there may be some evidence for older women.

Malmgren et al from the Swedish Cancer Institute in Seattle reported on findings to suggest the benefit of continued breast cancer screening in older women.

The researchers recently looked at the impact of mammography detection on older women by studying data from an institutional registry that includes more than 14,000 breast cancer cases with 1,600 patients aged older than 75 years.

The majority of mammography-detected cases were early stage, while physician- and patient-detected cancers were more likely to be advanced stage disease. Patients with mammography-detected invasive breast cancer were more often treated with lumpectomy and radiation and had fewer mastectomies and less chemotherapy than patient- or physician-detected cases.

Mammography detection was associated with a 97% five-year disease-specific invasive cancer survival rate, compared with 87% for patient- or physician-detected invasive cancers.

“Mammography enables detection when breast cancer is at an early stage and is easier to treat with more tolerable options,” said Dr. Malmgren. “In this study, older women with mammography-detected invasive cancer had a 10% reduction in breast cancer disease-specific mortality after 5 years.”

This all has little to do with ultrasound but everything to do with the doctor patient relationship. Ultimately, the decision to screen or not to screen should properly rest with the patient and her doctor, based on medical evidence, not cost. Older folks are people too.

If you've any questions or need to schedule an ultrasound, please call (718) 925-6277.