Life expectancy should be a major reason why people living with breast cancer continue with screening mammography.
At least that’s the push behind the first screening mammography guide published Thursday, January 28, for this patient group. A national panel of experts shared their recommendations in Oncology JAMA.
The group, led by Rachel A. Freedman, MD, MPH, medical director at the Dana-Farber Cancer Institute Cancer Care Collaboration, noted that these guidelines are not prescribed, but are a good starting point for talking about mammographic plans and options with the elderly. patients.
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“The purpose of the guidance is to support clinicians to maintain these conversations with patients and to make an individual personal decision for each woman,” she said, noting that printed materials designed to help patients quantify the risk of recurrence and increase their weight and mammography disadvantages will be available.
The current level of care with mammography for all breast cancer survivors is annual screening. However, there is little guidance, she said, for how providers should design services for older women and whether life expectancy, relapse risk, patient preferences, or trade-offs should be related to the partial test. take into account in any decisions.
“The result is that the use of mammography for elderly survivors has been very inconsistent,” Freedman said. “With the number of older women diagnosed with breast cancer increasing in the coming years, it is important that we find ways to make individual decisions for each patient’s situation and preferences. ”
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These are the questions that a group of representatives from primary breast cancer care, geriatrics, radiation, survival, and nursing groups tried to answer. A panel of 18-member patients joined them to review the existing literature on the risks of breast cancer in older women. They also considered the advantages and disadvantages of continuous mammography in these elderly patients.
From their discussion, the group climbed the guidelines, which were revised by the International Society for Geriatric Oncology:
- Stop mammography for breast cancer survivors over 75 who have a life expectancy under the age of five, even for those with a history of higher-risk tumors, such as triple-negative or ERBB2-positive.
- Consider previous mammography for survivors with a five to 10-year life expectancy.
- Continue annual or biennial mammography in survivors with a life expectancy of more than 10 years.
- Stop mammography for women over 85 with a life expectancy under the age of five unless the woman is in remarkable health or wants to continue screening.
Based on their literature review, the team’s proven mammography offers a slightly to moderate benefit to older women, and can produce deceptive benefits that can lead to anxiety, unnecessary testing, and over-treatment. Fortunately, they said, breast cancer has a low risk of breast cancer in both breast cancers, especially those women who have previously received hormone replacement therapy for hormone-receptor-advanced tumors.
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