Breast Cancer Screening for Older Women Has Trade-offs

Providing older women with necessary information in order to make an informed decision regarding breast cancer screening should be a priority, according to an article in the International Journal of Radiation Biology.

Researchers from Australia sought to determine the benefits and harms of biennial breast cancer screening for women aged 70 to 74. The Australian national breast cancer screening program had gradually invited women in this age group to attend screening, and the researchers evaluated the benefits and harms of the screening. They calculated the estimates of relative risk reduction of breast cancer mortality and the risk of overdiagnosis using measures taken from the Independent U.K. Panel on Breast Cancer Screening.

The researchers estimated screening specific outcomes (recalls for further imaging, biopsies, false positives, and interval cancer rates) from data published by BreastScreen Australia.

The results showed that when compared with stopping screening at age 69, screening 1,000 women to age 74 was likely to avert one more breast cancer death, with an additional 78 women receiving a false positive result and another 28 women diagnosed with breast cancer, of whom eight will be overdiagnosed and overtreated.

The extra five years of screening results in approximately seven more overdiagnosed cancers to avert one more breast cancer death. The researchers concluded that by extending screening mammography in Australia to older women, there was less favorable harm to benefit ratio than stopping at age 69. They suggested that supporting informed decision making for this age group should be a public health priority.