Breast cancer screening in older women has been a much discussed topic in the past few years. In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended that mammograms shouldn’t be encouraged in women ages 75 and older because they might not benefit from the screenings. The USPSTF made this recommendation because no research had shown that these women would benefit from regular mammograms. The USPSTF also recommended that breast cancer screening should start at age 50 instead of 40 and that mammograms should be done every other year instead of every year.
Several medical organizations and advocacy groups, including the American Cancer Society and Breastcancer.org, didn’t agree with the USPSTF conclusions and ignored the recommendations. The recommendations were very controversial and were not widely adopted by doctors.
A new analysis of information from the large Women’s Health Initiative study has found that women 75 and older who didn’t get regular mammograms had a higher risk of dying from breast cancer. The results suggest that older women need regular screening.
The study was presented at the 2013 American Association for Cancer Research Annual Meeting. Read the abstract of “Mammography interval and breast cancer mortality in the Women’s Health Initiative.”
Because the USPSTF recommendations caused so much controversy, researchers wanted to see if older women got benefits from regular screening mammograms.
The study looked at 8,663 women ages 75 and older in the Women’s Health Initiative study who were diagnosed with breast cancer during about 12 years of follow-up. The women reported how long before diagnosis they had had a mammogram:
- between 6 months and 1 year: 30% of the women
- between 1 and 2 years: 47% of the women
- between 2 and 5 years: 17.2% of the women
- more than 5 years or hadn’t had a mammogram: 5.8% of the women
Compared to women who had a mammogram 6 months to 1 year before being diagnosed, women who:
- had 2 to 5 years between their last mammogram and a breast cancer diagnosis had an 87% higher risk of dying from breast cancer
- had their last mammogram more than 5 years before a diagnosis or had never had a mammogram were more than three times as likely to die from breast cancer
Women who didn’t get regular mammograms also were more likely to have estrogen-receptor-negative breast cancer, which means hormonal therapy wouldn’t be an effective treatment. These women also were more likely to be diagnosed with more advanced-stage breast cancer: cancer that had spread to the chest wall or other parts of the body away from the breast.
Women age 66 will live another 22 years on average. And many women aren’t average in terms of health status, life expectancy, or risk of dying of breast cancer or another disease. Nearly all experts would agree that annual screening doesn’t make sense for an older woman who wouldn’t want to be treated for breast cancer because of personal preferences or other health issues. Still, many women ages 66 or older are in reasonably good health and would want to be treated should they be diagnosed with breast cancer.
Breastcancer.org believes that the importance of diagnosing breast cancer early, when it’s most treatable, doesn’t get any less important as a woman gets older. Regular screening mammograms make sense for any woman ages 75 and older who would want to be treated for breast cancer should she be diagnosed.
For more information on mammograms and other tests to detect breast cancer, visit the Breastcancer.org Breast Cancer Tests: Screening, Diagnosis, and Monitoring pages.