Researchers and physicians talk a lot about when women should start getting routine mammograms, but when should women stop getting mammograms? As it turns out, women should never stop, according to a new study presented at the annual meeting of the Radiological Society of North America (RSNA).
Earlier guidelines released by the United States Preventive Services Task Force (USPSTF) in 2009 stated there was no sufficient evidence about the benefits of screening women for breast cancer using mammography in women age 75 and older. The current recommendation from the USPSTF is that women between 50 and 74 get a mammogram every other year and stop getting screened at 75.
The USPSTF guidelines were controversial then and are still regarded as controversial now for other professional groups and physicians. One such physician is Dr. Mona Alqulali, a Bettendorf, Iowa, OB-GYN who advises that preventative health screenings such as mammograms are beneficial at any age.
"People are living longer than ever before and staying healthy well into their 70s. Preventative health screenings play a large part in that - at any age," said Alqulali.
The study, conducted by the Elizabeth Wende Breast Care, LLC, a breast clinic in Rochester, New York, shows that women over 75 still benefit from mammography screenings because there is still a risk of developing breast cancer over that age. The clinic was the first dedicated breast clinic in the United States.
According to the Susan G. Komen Foundation, an organization that works to increase awareness, education and prevention of breast cancer, the median age of breast cancer is 62, but the rate of developing breast cancer is the highest over the age of 70.
During the Wende study, researchers analyzed the data of 763,256 screening mammography exams conducted at the clinic between 2007 and 2017. Their research found that mammography-detected cancer was diagnosed in 3,944 patients.
Researchers then further analyzed the information to identify the types of cancers and frequency of their occurrence in women age 75 and older.
The study authors found that during the 10-year period they analyzed, there were 76,885 patients (10 percent) age 75 and older. Of this group, the average age of the patients was 80.4. The rate of diagnosis among this group was 8.4 per 1,000 exams.
Of those diagnosed, 82 percent of the women had invasive cancers, of which 63 percent were grade 2 or 3, which grow and spread at a rapid rate.
Ninety-eight percent of the cancers found were able to be removed surgically.
Seven percent of those diagnosed over the age of 75 had cancer present in their lymph nodes.
Of those with cancer, 17 percent were not surgically treated due because of advanced patient age or poor overall health.
Why Are Mammograms So Important?
"Mammograms can detect breast cancer two years before it can be felt or noticed by a woman or a physician, and early detection of breast cancer means increased chance of survival," Alqulali said.
Researchers on the Wende study advise women to seek out mammogram screenings as young as 40 and past 75.
"Women with a family history of breast cancer or other risk factors should talk to their physician about when they should start screenings," said Alqulali.
In addition to age and family history, other risk factors include lifestyle and behavioral factors, such as obesity, sedentary living and smoking. Women with denser breasts are also more likely to develop breast cancer, and because of their dense breasts, their cancer may be hard to find with a conventional mammogram.
"In the case of dense breasts, 3-D imaging technology is helpful for early detection," Alqulali said.
Radiological Society of North America. "Women benefit from mammography screening beyond age 75." ScienceDaily. ScienceDaily, 21 November 2018.