Reevaluating the Efficacy of Breast Cancer Screening in Older Women
New research suggests that breast cancer is often overdiagnosed in women aged 70 to 85, leading to unnecessary treatments that do not improve their quality of life. The study calls for a reevaluation of screening practices and more informed discussions with patients in this age group.
HCN Medical Memo
This study underscores the importance of nuanced conversations with older female patients about the risks and benefits of breast cancer screening. Given the high rates of overdiagnosis and the potential for unnecessary treatments that don’t improve quality of life, it’s crucial to align screening decisions with individual patient values and life expectancy.
- The study, published in the Annals of Internal Medicine, involved 54,635 women aged 70 and above and followed them for 15 years.
- An estimated 31% of women aged 70 to 74 were overdiagnosed, 47% of those aged 75 to 84, and 54% of those aged 85 and older.
- Dr. Ilana Richman, the paper’s lead author, emphasized the need for better tools to identify which women may benefit from screening and which are unlikely to have progressive breast cancers.
- The concept of overdiagnosis presents challenges in patient-provider communication and complicates clinical decision-making.
“Overdiagnosis refers to a phenomenon where we find breast cancers through screening that never would have caused symptoms. Overdiagnosis can occur when cancers grow very slowly or if a person’s life expectancy is short.”
– Dr. Ilana Richman, Assistant Professor of Medicine at the Yale School of Medicine
- Improved detection technologies like 3D mammography and MRI have led to increased rates of overdiagnosis.
- The US Preventive Services Task Force recently recommended starting routine breast cancer screening at age 40 but acknowledged the need for more research for women over 75.
- Breast cancer rates peak among women aged 70 to 74, but the risk decreases as women age into their 80s, often due to mortality from other causes.
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