Women aged 75 and older should continue to perform mammography screening as a high occurrence of breast cancer was found among this older age group in a new study that will be presented next week at the annual meeting of the Radiological Society of North America (RSNA).
There has been controversy in recent years on what the cut-off age should be for breast cancer screening, when in 2009 the United States Preventive Services Task Force (USPSTF) issued guidelines instructing there was insufficient evidence to weigh the benefits vs harm of mammography screening in women aged 75 or older. On the other hand, other professional groups have come out in favour of women continuing to receive mammography screening if they are in good health.
"Ongoing debate exists regarding the age to cease screening mammography," said head of the study team Dr. Stamatia Destounis, radiologist at Elizabeth Wende Breast Care in Rochester, NY, in a statement released by the RSNA. "Our findings provide important data demonstrating that there is value in screening women over 75 because there is a considerable incidence of breast cancer."
Dr. Destounis and her research colleagues analysed the data derived from 763,256 mammography screening exams at Elizabeth Wende Breast Care spanning a decade between 2007 and 2017. Of those, screening detected cancer in 3,944 patients and researchers went on to analyse and identify how many incidents and what types of cancers were diagnosed in women aged 75 years and older.
The found that 76,885 of the patients (10 percent) included in the study were of age 75 and older. The average age of the patients was 80.4. They diagnosed a total of 645 malignancies in 616 patients, for a cancer rate of 8.4 detections per 1,000 exams in this older age group.
"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," said Dr. Destounis.
In addition, the researchers determined that 82 percent of the cancers were invasive, of those 63 percent diagnosed as grade 2 or 3, which have a faster growth and spread rate. Of the cancers they found, 98 percent were able to be surgically treated, and seventeen cancers could not be surgically treated because of the overall degraded patient health or advanced patient age.
"Most of the tumors found in this age group were invasive, and almost all of these patients--98 percent--underwent surgery," Dr. Destounis said.
Early detection provides better treatment options and improved survival outcomes for patients and mammography screening is critical in the early detection of breast cancer as it can show changes in the breast up to two years before a woman of her doctor can feel them.
Dr. Destounis advises women over 75 years old who are relatively healthy should continue routine screenings. "The benefits of screening yearly after age 75 continue to outweigh any minimal risk of additional diagnostic testing," she said.
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