Are mammograms still effective?

Healthy women over the age of 75 might not benefit from continuing breast cancer screening, according to new research.

Dr Otis Brawley of Johns Hopkins University explained in an editorial that while many studies showed the effectiveness of mammograms starting at age 50, there was little evidence of when screening should stop.

An important question in cancer screening is the age at which it should stop. At some age, the modest potential harm associated with screening will outweigh the benefits because the latter accrue in the future. 

The research used data to estimate the breast cancer mortality of women under two strategies – continuing versus stopping screening in older women.

They found a small mortality benefit for continuing to screen women between the ages of 70 to 74, but not those between 75 to 84. 

Researchers compared deaths from breast cancer over eight years’ follow-up in women who continued getting yearly mammograms and those who stopped screening. 

The researchers studied data on more than one 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.

Regardless of age, women were less likely to receive aggressive therapies (radical mastectomy, chemotherapy) for breast cancer if they continued screening.

Do you undergo annual mammogram screening? Do you think more research should be done on the benefits of screening after women reach a certain age?

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