by
Glenda Fauntleroy, DOTmed News | November 18, 2011
Most physicians advise women to begin having mammograms at age 40, but the screening test may more accurately detect breast cancer when women are aged 90 years and older, according to a recent study published in the American Journal of Roentgenology.
For years, the health care community has offered conflicting advice for physicians and patients regarding what age, if any, mammograms should be utilized as a preventive screening test for women.
In 2009, the U.S. Preventive Services Task Force started the controversy when it announced new guidelines recommending against routine mammography screening for women before the age of 50 and suggesting screening should only be done every two years and stopped at age 74. In contrast, the American Cancer Society and the National Cancer Institute both recommend annual mammograms beginning at age 40 and continuing for as long as a woman is in good health.
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In the new study, researchers used data from the Vermont Breast Cancer Surveillance System covering the years 1996 to 2006 and evaluated more than 400,000 mammograms that were taken of 96,193 women between the ages of 50 and 101 years old. Almost all (99 percent) of the mammograms were of white women, with the next largest group belonging to American Indian or Alaskan Native women.
The study found that the sensitivity of screening mammography increased from 77.3 percent for 50 to 59-year-old women to 93.8 percent for 90 to 101-year old women. Specificity increased from 98.7 percent for 50 to 59-year-olds to 98.8 percent in the older women. The cancer detection rate also increased -- jumping from 3.7 cases per 1,000 mammograms for 50 to 59-year-olds to 14.4 cases per 1,000 mammograms for 90 to 101-year-olds.
"Mammography for breast cancer screening among women older than 70 years appears to detect smaller, earlier stage, more invasive, and more commonly receptor-positive tumors," wrote the researchers.
The researchers say their results show the importance of discussing the potential benefits of mammography screening of women older than 65 years who have reasonable life expectancy.
