Growing older doesn’t cut down a woman’s risk of developing breast cancer and there should be cut-off age to stop breast cancer screening in older women well after menopause, show results of the largest-ever study of biopsy and mammography, the standard imaging exam for its screening.
An analysis of nearly 5.6 million screening mammograms and biopsies done in the US between January 2008 and December 2014 showed higher cancer detection rate in mammograms and biopsies in women ages up to age 90 years.
The study, done by researchers from the University of California in San Francisco (UCSF), was presented at the annual meeting of the Radiological Society of North America, adds support to guidelines that recommend screening decisions based on individual patients and their health status.
With an estimated 1.1 lakh new cases each year, breast cancer has replaced cervical cancer as the leading cancer among women in India. The HPV vaccine protects against cervical cancer, but screening and early detection and treatment is the only protection against breast cancer.
Controversy has surrounded international guidelines on how often and till when should women be screened for cancer. In 2009, the US released new guidelines that said there was not enough evidence to assess the balance of benefits and harms of screening mammography in women aged 75 years or older.
“There has been a lot of controversy, debate and conversation regarding the different breast cancer screening guidelines, even among major national organisations, over the past few years,” said Cindy S. Lee, M.D., assistant professor in residence at UCSF.
Her team analysed data from the US National Mammography Database of nearly 5.6 million screening mammograms performed over a 7-year period between January 2008 and December 2014 in 150 facilities across 31 states. A review of the patients’ demographics, screening mammography results and biopsy results showed a gradual upward trend in cancer detection.
The UCSF team recommends the decision whether or not to stop screening should be based on a person’s health history and preferences. “We now know that the risk of breast cancer increases with age,” Dr Lee said. “With the uncertainty and controversy about what age to stop breast cancer screening, we addressed this gap in knowledge and have collected enough data to make a conclusion.”