No Age Cut-off for Breast Cancer Screening? — Physician’s First Watch
No Age Cut-off for Breast Cancer Screening?
By Amy Orciari Herman
Mammographic screening for breast cancer should not be discontinued solely based on patient age, suggests a JAMA Oncology research letter.
Researchers studied 5.7 million screening mammograms performed across the U.S. from 2008–2014. The mean cancer detection rate increased with age, from 1.72 per 1000 screens for women aged 40–44 to 6.58 per 1000 for women aged 90 and older. Meanwhile, the mammography recall rate decreased with age, from 14.5% among the youngest women to 6.1% among the oldest.
The U.S. Preventive Services Task Force says there's not enough evidence to make a screening recommendation in women aged 75 and older, while the American Cancer Society advocates screening as long as women are in good health and expected to live at least 10 more years.
NEJM Journal Watch Women's Health Editor-in-Chief Dr. Andrew M. Kaunitz commented: "Although it is clear that the prevalence of breast cancer increases with age, to what degree women over age 75 benefit from detection of these tumors (often indolent in this setting) is less clear. Accordingly, providing guidance to our patients older than age 75 regarding continuing or stopping screening mammograms is best accomplished with shared decision-making."