21 February 2017

Research Recommends Continued Breast Cancer Screening Mammography for Older Women

New research about the appropriate age limit for breast cancer mammography screenings, presented at the Radiological Society of North America’s annual meeting late last year, challenges current conventional recommendations. While the U.S. Preventive Services Task Force (USPSTF) recommends that women undergo screenings every two years until age 74, researchers from the University of California at San Francisco assert this age limit may be arbitrary after finding that the precision of breast cancer mammography screening, and thus the rate of cancer detection, increases significantly as women age.

Pulling from the American College of Radiology National Mammography Database, the research team examined 5.7 million mammography screenings from 2.6 million women 40 years or older. The team found the average national cancer detection rate to be 3.74 per 1000 screenings, while the average recall rate of screenings leading to a call-back for additional workup was 10 percent. Further, the rate of cancers found in cases recommended for biopsy was 20 percent, and the rate of cancers found in women who underwent biopsy was 29 percent.

Next, researchers stratified the data into five-year age groups to identify any trends. They found that the recall rate decreased progressively every decade and that detection rates increased progressively with age. The team concluded that doctors should continue to recommend mammography screenings for women 75 years and older if it is medically appropriate based on preexisting conditions and life expectancy.

This conclusion coincides with growing evidence of high breast cancer incidents in older women. A similar study published in the May 2015 edition of the American Journal of Roentgenology found a significant detection of carcinomic and invasive breast cancer tumors in women 75 years and older at a rate of 5.9 per 1000 screenings. While detection rates for older women seem to have recently decreased, as the American Cancer Society states in its 2015-2016 report, almost 58 percent of all breast cancer deaths occur in women older than 65. Within this same group, women 80 years or older make up 46 percent of all deaths. 
 
Ultimately, at a time when the medical community is questioning the effectiveness of screening mammography, research still supports the necessity of continued, quality preemptive care for all – and especially older – women.