Women Over 75 Who Have Chronic Conditions Don’t Need Mammograms, Study Says
A study published in the Journal of the National Cancer Institute (JNCI) found that women over 75 with chronic conditions like heart disease and diabetes don’t benefit from mammograms.
It’s a statement that seems shocking, given the popularity and efficacy of the standard breast cancer screening tool. Mammograms help detect breast cancer in its earlier stages, which in turn allows for swift treatment and better outcomes. According to the American College of Radiology, mammograms have helped lower breast cancer mortality in the U.S. by almost 40% since 1990.
But it seems that the help mammograms offer doesn’t extend past age 75 for some women. The study’s authors found that a woman over 75 is more likely to die from the chronic condition she already has before she even develops breast cancer.
“For those 75 and over with chronic illness, the benefit of continued mammography is minimal. Women 75 to 84 are 123 times more likely to die of other causes than breast cancer,” said the study’s senior author, Dejana Braithwaite, who’s an associate professor of epidemiology and oncology at Georgetown University’s Lombardi Comprehensive Cancer Center in Washington, D.C. Women who are 85 and older have even less of a benefit.
For this study, researchers analyzed the data of 222,088 women in the U.S. between the ages of 66 and 94. All of the women had undergone at least one mammogram between 1999 and 2010.
They looked at overall breast cancer cases, deaths from breast cancer, and deaths from other causes. They found that, over this 10-year period, 7,583 of the women were diagnosed with invasive breast cancer and 1,742 with DCIS, or stage 0 breast cancer, which is non-invasive.
Only 471 women out of 222,0888 died from breast cancer while nearly 90 times as many — 42,229 — died from other causes.
For women who were older than 75, researchers found that diagnoses of invasive breast cancer and DCIS lessened, regardless of a woman’s overall health. The 10-year risk of dying from breast cancer stayed about the same from ages 66 to 94, and was relatively small, causing 0.2% -0.3% of all deaths.
Researchers say that their findings do not indicate that all women over 75 should skip mammograms — only those with chronic conditions.
For example, the American Cancer Society recommends ceasing mammograms when life expectancy is less than 10 years. The U.S. Preventive Services Task Force (USPSTF) offers no mammogram recommendation for women 75 and older, stating that there is not enough evidence to make a suggestion either way. In Europe, many breast cancer programs say mammogram screening can stop for women when they reach between 69 and 74 years old.
The age a woman should stop screening should be made on an individual basis, and based on her health, needs, and preferences, the study’s authors are quick to emphasize.
“In healthy women age 75 and older, perhaps mammograms may make sense,” Braithwaite said. “It’s important to individualize the decision. Women should discuss with their providers the potential benefits of continuing mammography.”
The first author of the study, Dr. Joshua Demb, agrees. He’s a postdoctoral researcher at the University of California San Diego.
“Our research underscores the need to individualize screening decisions among older women,” Demb said. “To that end, we hope that our analyses contribute to developing effective tools that older women can use in consultation with their health care providers to decide a screening strategy that is best for them.”