Clinical efficacy of mammographic screening in the elderly.

Abstract

Mammographic screening is at least as effective in detecting cancers for which there is a favorable prognosis in women aged 65 years and older as it is in women aged 50-64 years. Because the efficacy of screening in younger-group women has already been proved, it may be inferred that screening also benefits elderly-group women.

Comparison of Screened and Nonscreened Breast Cancer Patients in Relation to Age: A 2-Institution Study

“…Patients in this age range often do not receive standard adjuvant chemotherapy, because of the existence of comorbidities, cognitive impairment, and poor social support, 37 which might result in undertreatment and higher BC-specific mortality. 38,39 Conclusion Our data confirm the usefulness of our screening program 6 and we speculate that extending BCSPs to women younger than age 50 and older than 70 years could bring about mortality benefits.…”

American Cancer Society Guidelines for Breast Cancer Screening: Update 2003

“…Faulk 87 compared data for women in the age groups 50 to 64 and 65 and over. Abnormal mammogram interpretations and number of biopsies were comparable among the women in both groups, but positive predictive value, biopsy yield, and rate of cancers per thousand screens were higher in the older age group as would be expected on the basis of higher disease prevalence.…”

Question

“…A 75-year-old woman can be expected to live 12 more years, and an 85-year-old woman, 7 more years [3]. A woman who lives to age 65 can be expected to live an additional 18 years (age at death, 83 years).…”

“…Questions will be answered by consultants selected by the Editor. Additionally, tumor size and stage in screened women over 65 are similar to tumor size and stage in screened women ranging in the 50-65 age group, a group known to benefit from screening mammography [3]. Answers supplied by radiologist consultants should not be considered inclusive of all approaches to a problem or exclusive of other methods of obtaining the same result.…”

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The journal invites readers to submit short, well-focused questions about specific topics that trouble them in their practice. A 75-year-old woman can be expected to live 12 more years, and an 85-year-old woman, 7 more years [3].Elderly patients present with breast cancer typically at a later stage than younger women in part because of the underutilization of physical examination and mammography. The author's name and address should be included, but these will not be published if so requested.

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