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Mammogram Study: Over 65? Go Every 2 Years

February 5, 2013
Written by: , Filed in: Breast Imaging, Daily
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Women older than 65, according to a new study, derive just as much cancer-screening benefit—at least in terms of finding large or late-stage tumors—if they have a mammogram every two years rather than every year. And biennial exams offer a bonus: far lower rates of false positives.

The study, led by researchers at the University of California, San Francisco, looked at data from 140,942 women who had mammograms at facilities that participated in a data linkage between the Breast Cancer Surveillance Consortium and Medicare claims. Of those women, 2,993 had breast cancer. Data were collected from January 1999 through December 2006. The women were ages 66 through 89 at the time they entered the study.

Senior author Karla Kerlikowske, MD, said flatly:

Women aged 66 to 74 years who choose to undergo screening mammography should be screened every two years. They get no added benefit from annual screening and face almost twice the false positives and biopsy recommendations, which may cause anxiety and inconvenience.

Dr. Kerlikowske is a professor of epidemiology and biostatistics at UCSF and director of the women’s clinic at the UCSF-affiliated Veterans Affairs Medical Center in San Francisco. She was quoted in a UCSF news release via EurekAlert! The study was published online today in the Journal of the National Cancer Institute.

The study found no significant difference in the rate of late-stage or large tumors between women screened annually and those screened biennially. Nor did the presence of other significant illnesses, such as diabetes or heart disease, make a difference.

There was, however, a huge difference in the 10-year cumulative probability of false positives among those ages 66 to 74: 48 percent among those screened annually, 29 percent among those screened biennially.

Lead author Dejana Braithwaite, PhD, said the study “fills an important information gap, since accountable care organizations do not address screening intervals or screening cessation in women of advanced age or with a significant burden of illness.” Dr. Braithwaite is an assistant professor of epidemiology and biostatistics at UCSF.

As the study notes, the U.S. Preventive Services Task Force recommends biennial mammography for women ages 50 through 74 and screening for women in their 40s on a case-by-case basis, with women consulting their doctors. It has found insufficient evidence one way or another to make a recommendation for women older than 74. The American Cancer Society recommends annual mammograms for every woman, starting at age 40 and “continuing for as long as a woman is in good health.”

We doubt that this or any other study will inspire changes to any of those recommendations anytime soon.

Related seminar: Chicago International Breast Course and The Society for the Advancement of Women’s Imaging

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