Physicians Debate Value of Routine Breast Cancer Screenings for Elderly Patients
Although annual breast cancer screenings are recommended for most women ages 40 and older, physicians debate the value of regular mammograms for elderly women, who are more likely to die from unrelated causes, the New York Times reports. A study published in May in the Journal of Clinical Oncology showed that among women ages 80 and older who were diagnosed with breast cancer, those who received regular screenings were more likely to find the disease early enough to avoid a mastectomy and survive at least five years than those who had not been screened for at least five years before their diagnosis. However, the "study may raise more questions than it answers," and it raises the "specter of frail women being dragged from nursing home beds to be screened for cancer when they are far more likely to die of heart disease or complications from a broken hip," the Times reports.
Harvard University mammography and preventive care researcher Mara Schonberg said that less than 2% of women ages 80 and older die of breast cancer and that a physician's time would be better spent encouraging these patients to exercise and get immunizations, as well as discussing problems in their daily life. Diana Petitti, vice chair of the HHS United States Preventive Services Task Force, said, "It gets back to the question: What is the goal of preventive care in the elderly," adding, "In my opinion, it's to maximize quality of life and function." She said the focus on regular mammograms could distract from more relevant problems such as high blood pressure, low mobility, depression, chronic pain, and impaired vision and hearing.
Guidelines issued by the task force set no cutoff age for screenings but say other conditions should be considered when deciding whether to screen patients. The Times reports that physicians say there is too little data on the benefits of regular mammograms in elderly women because large clinical trials on mammography typically focus on younger people and exclude the elderly. Robert Smith, the American Cancer Society's director of cancer screening, said, "A woman who's 70 still has close to 19 years of life left on average," adding, "As long as she's in good health and would be a candidate for treatment if she were diagnosed, she should continue to get mammograms" (Caryn Rabin, New York Times, 7/8).
The study is available online.
