I recently had a conversation with my sister about mammography for older women. She informed me that several of her friends over the age of 72 are no longer getting regular screenings because they don’t need them. It seems that there is some sort of misconception that once you are in your 70’s, you don’t have to be concerned any longer because you won’t get breast cancer. As I am not sure how this information is being perpetuated, I must say that this is very sad and perplexing that somehow this myth is even out there since I personally know several women whose breast cancer was diagnosed after the age of 75 and have been successfully treated. Therefore, I had to do some research into this matter to try to find an explanation.
Within the first source that I checked, I found the following specific information:
“Women age 55 and older should switch to mammograms every 2 years, or have the choice to continue yearly screening.
Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.”
These guidelines seem reasonable, generally speaking, except for the part that refers to a patient that is “expected to live 10 more years or longer”. Personally, I don’t know how one would ever be able to make such a determination of life expectancy, especially since new treatments and discoveries are being made on an almost daily basis. As a result, I think I would opt for excluding that as far as a recommendation is concerned as I am sure that any medical professional with whom I was dealing would know when such a screening would no longer be needed if my health had substantially declined.
The second source that I consulted provided the following:
For women between 50 and 74 years old, the USPSTF (U.S. Preventive Services Task Force) recommends a mammogram every two years. This age group benefits the most from mammography. Women from 60 to 69 are the most likely to avoid death from breast cancer due to mammogram screening.
The USPSTF made no recommendations for women aged 75 and up, due to lack of adequate science. It made no recommendation for or against 3-D mammography. It also did not change its 2009 recommendation against doctors teaching patients about self-exams.
These recommendations are for women at average risk. Women at higher risk should discuss screening with their doctors.
Here again, the recommendations are made for women at “average” risk but I don’t know how one makes that determination. In my case, I didn’t have a family history of breast cancer of which I was aware and had no reason to think that I was even at average risk. The other point that I found of most interest is that the recommendations indicate, “women between 50 and 74 years old is the age group that benefits the most from mammography”. This leads me to then ask why would someone believe that screening is no longer needed when you turn 75? Even more troubling is the fact that no recommendations are even provided for ages 75 and above.
Of course, each person’s situation is different and I believe that we need to defer to the expertise of the medical professionals. However, I also believe that we need to advocate for ourselves and not make random decisions about not having a screening or test done just because you assumed that you don’t need to do so or your friend tells you that such is the case. Until we know more about the causes of breast cancer, we can’t assume to “know” whether we are at risk at any age. Just ask my 91-year-old family friend who was screened and successfully treated at the age of 82. She had no family history of breast cancer but because she continued screening, she was diagnosed at an early stage and successfully treated. I truly believe that a yearly screening should take place as a part of our annual physical exam until such time that we can definitively advise women that they are no longer needed.