Screening Mammograms In Elderly Should Be Based on Expected Survival, Not Age

Susan K. Boolbol, MD, FACS Chief, Division of Breast Surgery Chief, Appel-Venet Comprehensive Breast Service Co-Director, Breast Surgery Fellowship Mount Sinai Beth Israel Associate Professor of Surgery Icahn School of Medicine at Mount Sinai New York, NY 10003

Dr. Boolbol

MedicalResearch.com Interview with:
Susan K. Boolbol, MD, FACS
Chief, Division of Breast Surgery
Chief, Appel-Venet Comprehensive Breast Service
Co-Director, Breast Surgery Fellowship
Mount Sinai Beth Israel
Associate Professor of Surgery
Icahn School of Medicine at Mount Sinai
New York, NY 10003

Medical Research: What is the background for this study? What are the main findings?

Dr.Boolbol: The background for this study is predicated on the USPSTF’s recommendations that there is insufficient evidence to continue the use of screening mammography in women over the age of 75. According to the American College of Radiology, cancer detection rates via screening mammography should be at least 2.5 per 1000 mammograms at an institution, with reported rates as high as 4.7 cases per 1000. We reviewed 2057 screening mammograms in women aged 75 and older. We found 10 cases of breast cancer in this group. Of these cancers, 60% were invasive breast cancer. The breast cancer detection rate in this cohort was 4.9 per 1000 screening mammograms.

Medical Research: What should clinicians and patients take away from your report?

Dr.Boolbol: Screening mammography in this age group (75 and older) should be based on co-morbidities and not age. We should make recommendations based on a patients health status and expected survival not based on their age.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr.Boolbol: This study is based on our individual experience. These findings should be validated by examining larger groups of patients. We should also examine the types of breast cancer detected and the types of treatment that the patients required.

In our current practice, we continue to make screening recommendations based on a patients predicted lifespan not just on their age. If an individual’s lifespan is 10 years or greater, screening is recommended. This study demonstrates that even in an older population, there is a screening benefit.

Citation:

Abstract presented at the 2015 SABCS

Screening mammography in women over age 75: Is it beneficial?

Cate SP, Kohli MK, Gillego A, Chadha M, Fulop T, Boolbol SK. Mount Siniai Beth Israel Medical Center, NY, NY

Susan K. Boolbol, MD, FACS (2015). Screening Mammograms In Elderly Should Be Based on Expected Survival, Not Age