Mammograms not helpful in women 75 and older, study
finds
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[February 25, 2020]
By Julie Steenhuysen
CHICAGO (Reuters) - Women 75 and older do
not benefit from regular screening mammograms, researchers reported on
Monday, offering some of the first evidence on whether screening makes
sense in these women.
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Although studies clearly show mammograms starting at age 50 prevent
breast cancer deaths, until now, doctors have had little evidence
about when to end screening, Dr. Otis Brawley of Johns Hopkins
University and former chief medical officer of the American Cancer
Society, wrote in editorial in the Annals of Internal Medicine.
"The study is important because a third of all American women die of
breast cancer are diagnosed after the age of 70," Brawley said in a
telephone interview.
The U.S. Preventive Services Task Force, which sets screening
guidelines, currently states that the evidence is insufficient to
assess the harms and benefits in women 75 and older. Recommendations
by other groups vary.
As a result, some 52% of women in the United States aged 75 and
older still get regular mammogram screening, according to the paper
published on Monday in the Annals of Internal Medicine.
"A lot of women over 75 and 80 are receiving mammograms," study
author Dr. Xabier Garcia-De-Albeniz of the Harvard School of Public
Health, RTI Health Solutions and Massachusetts General Hospital,
said in a telephone interview.
Brawley said clinical trials cannot be done to provide that evidence
because too many people are convinced of the benefits of
mammography, and would consider withholding screening to be
unethical.
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Garcia-De-Albeniz and colleagues set out to provide that evidence using claims
data from the federal Medicare insurance program for the elderly. They studied
data on more than 1 million women aged 70 to 84 who underwent mammograms from
2000 to 2008. Women in the study had a life expectancy of at least 10 years and
no prior breast cancer diagnosis.
They found that in women aged 70 to 74, the benefit of screening outweighed the
risks, which can include overdiagnosis, overtreatment and the anxiety of a
potential breast cancer diagnosis. In women 75 to 84, screening did not
substantially reduce the risk of dying from breast cancer.
The reason is likely that by 75, women are more likely to die from heart disease
or neurological diseases such as dementia than breast cancer, the authors said.
Brawley said the findings underscore the need for more research to understand
breast cancer in older women and better treatments for women in this age group.
(Reporting by Julie Steenhuysen; Editing by Marguerita Choy)
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