Stamatia Destounis MD, FACR, FSBI, FAIUM Elizabeth Wende Breast Care Clinical Professor University of Rochester Imaging Sciences Rochester, NY 14620

Women Benefit from Mammography Screening Beyond Age 75 Interview with:
Stamatia Destounis MD, FACR, FSBI, FAIUM
Elizabeth Wende Breast Care
Clinical Professor University of Rochester Imaging Sciences
Rochester, NY 14620 What is the background for this study? What are the main findings?

Response:  The current breast cancer screening recommendations in the United States are unclear regarding when to stop screening. Several societies with published recommendations conflict in regard to when to discontinue screeningmammography. There is little evidence studying the benefit of annual mammography in the population of women 75 and older.

Due to this, we felt that it was a very important and timely topic to investigate, with the goal of providing further guidance on why screening mammography may be beneficial in this older population. What should readers take away from your report?

Response: Mammography is the gold standard for breast cancer screening and has substantially reduced breast cancer mortality.  Routine annual screening mammography provides the most benefit – detecting cancers when they are smaller, lower stage and grade, requiring less invasive treatment and better overall prognosis. Risk for the development of breast cancer increases with age – nearly 1/5 of breast cancers occur in women 75 and older.  Specifically, in our study, while this age population made up a small percentage of our overall screening population, they made up 16% of all screen-detected cancers diagnosed.  We know that mammography performs extremely well in the elderly population. We have seen through research that the recall rate is low, and the positive predictive value for biopsy and cancer detection rate are higher than the other age groups.  Tumors identified with screening mammography in our study were small in size, and a majority of patients were node negative, and low stage.

As the current average life expectancy for American women is 81.30 years, with one out of 10 living past age 95, these findings of small invasive tumors allow this population the greatest chance of finding a potential cancer early. Early cancer detection through continued annual mammograms result in needing less invasive and less taxing treatment and allows these women to continue living their lives.  98% of our patients were able to undergo surgery. What recommendations do you have for future research as a result of this work?

Response:  As mentioned earlier, there are very few randomized controlled trials on screening of the population of women over 74 years of age, so our best available data at this time is from observational studies and prediction models.

From the available data we do have, we have seen that mammography performs better in this population than many other age-groups attending screening – with a lower recall rate, and a higher cancer detection rate/PPV. Given these results, we would recommend a prospective randomized trial measuring the benefit to women over 74 years of age from yearly mammography, as we believe the results would mirror the findings we have discussed. 

We have no disclosures thank you for the opportunity to discuss our results. 

Citation: RSNA 2018 abstract:

Screening Mammography: There is Value in Screening Women Aged 75 and Over

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Last Updated on December 3, 2018 by Marie Benz MD FAAD