Should Women Over Age 75 Get Mammograms? Depends on Their Health

Guidelines surrounding mammograms for women 75 years of age and older have long been a source of debate.Now, a new study suggests a woman’s health status, and not her age, should be the deciding factor.The study was presented recently at the annual meeting of the Radiological Society of North America.
In it, researchers suggest women age 75 and over who are healthy should continue getting mammograms due to the comparatively higher incidence of breast cancer among this age group.
But women who aren’t healthy may not need to continue screening.
The reason is simple. Mammograms aren’t considered as essential for women whose life expectancy is shorter.
“The current breast cancer screening recommendations in the United States are unclear regarding when to stop screening. Several societies with published recommendations conflict. Because of 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 population,” Dr. Stamatia Destounis, study author and attending radiologist at Elizabeth Wende Breast Care in New York, told Healthline.
Mammography is a crucial element in the early detection of breast cancer, as it can show breast changes up to a year before a physician or a patient can feel them.
Yet, confusion reigns over whether mammograms should continue or cease at age 75.
“The U.S. Preventive Services Task Force recommends stopping at age 75 as there is limited data on the survival benefit (the reason we do any screening test is because it impacts survival) to mammography over age 75. The American Cancer Society and American Society of Breast Surgeons recommend every other year over age 75 if life expectancy is greater than 10 years. The American College of Obstetricians and Gynecologists and National Comprehensive Cancer Network recommend individualizing recommendations, and the American College of Radiology recommends mammography if life expectancy is greater than five to seven years,” Dr. Deanna Attai, assistant clinical professor at the David Geffen School of Medicine at the University of California Los Angeles, told Healthline.
“Rather than a blanket statement that everyone over age 75 should get a mammogram, many guidelines recommend that if the woman has a life expectancy of at least five years and is in good general health, then it is reasonable to continue screening mammography. For those women not at high risk, every other year is also reasonable, but individualization is important,” she said.
In undertaking her study, Destounis and her colleagues analyzed data from 763,256 mammography screenings between 2007 and 2017.
Of the patients screened, cancer was diagnosed in 3,944 patients. Ten percent of the women analyzed for the study were ages 75 and older.
In all, 645 malignancies were diagnosed across 616 patients. The rate of cancer detection was just under eight-and-a-half detections for every 1,000 exams in that age group.“Our study found that most of the cancers detected were invasive, not DCIS, and were of a variety of nuclear grades, including grades 2 and 3, supporting that these are the cancers that we want to find and get treated.” Destounis said.
“Our message is that there are benefits of screening yearly after the age of 75. Mammography continues to detect invasive cancers in this population that are node negative and low stage, allowing these women to undergo less invasive treatment. The age to stop screening should be based on each woman’s health status and not defined by their age,” she said.