Rethinking Screening Mammography in Women Aged 75 and Older
Posted: Tuesday, December 11, 2018
Women aged 75 years and older should continue to undergo screening mammography because of the comparatively high incidence of breast cancer found in this age group, according to a study presented at the 2018 Radiological Society of North America (RSNA) Annual Meeting (Abstract SSA01-04). According to Stamatia V. Destounis, MD, a radiologist at Elizabeth Wende Breast Care, LLC, in Rochester, New York, and colleagues, women 75 of age and older made up 16% of all patients diagnosed with screen-detected cancers, and most of the cancers found among this age group were invasive.
“The benefits of screening yearly after age 75 continue to outweigh any minimal risk of additional diagnostic testing,” stated Dr. Destounis in an RSNA press release.
The investigators analyzed data from 763,256 screening mammography exams between 2007 and 2017. Screening-detected cancer was diagnosed in 3,944 patients. There were 76,885 patients 75 years of age and older included in the study. A total of 645 malignancies were diagnosed in 616 patients, for a cancer rate of 8.4 detections per 1,000 exams in this age group.
In total, 98% of the cancers found were able to be treated surgically. Positive lymph nodes were reported at surgical excision in 7% of the patients. Seventeen cancers were not surgically treated due to advanced patient age or overall degraded patient health. Most of the cancers diagnosed were low grade, a significant number were invasive (81%), over half were grade 2 or 3, and a majority were lower stage (0 or I).
From their findings, the investigators concluded that screening mammography should be performed in women aged 75 and older, given the incidence of breast cancer that exists. The investigators concluded: “While ongoing debate exists regarding the age to cease screening mammography, citing lack of research in the aging population, our study demonstrates the value of screening women 75 and over.”
