Mammograms After 80?
Dear Breast Friend, I am turning 80 on my next birthday and I am wondering if I still need to have a screening mammogram. I’ve heard confusing information about when I should stop coming in for my yearly exam. Sincerely, almost 80 and energetic.
Dear Almost 80, Happy almost-birthday! You are not alone in feeling confused about how long screening for breast cancer should continue and when or if your should stop screening. The reason this may seem like it is not straightforward is that the decision of when or if to stop screening mammograms is unique for every woman. There is no age-based end date! The official recommendation from the American College of Radiology is that yearly screening mammograms can be stopped when a woman is expected to live for only another 5-7 years.
Since no one, not even your doctor, has a crystal ball for your health and life expectancy it can be hard to determine when you have reached a point where backing away from screening makes sense. “As a breast radiologist, instead of trying to figure out life expectancy, I think it can be more helpful to ask yourself this question - If I were to find out that I have breast cancer, would I want to or be able to pursue treatment for that cancer?” says GRACE breast imaging expert Dr. Rachel Preisser. When your answer to this question is “No way!” because you have many other health issues that would make it difficult to undergo treatment, then it may be a good time to have a discussion about whether to continue yearly screening mammograms with your primary care doctor. That said, many women do continue their screening mammography program beyond their 80th birthday, especially if they are otherwise healthy and living independently. Advancing age and being a woman are two of the biggest risk factors for breast cancer and screening mammography helps us find breast cancers when they are small and treatable. “In my career I have seen multiple examples of women in their late seventies or eighties come in with a large breast lump that they happened to feel which ends up being an advanced cancer. Our opportunity to find the cancer when it was too small to feel was lost when screening mammogram were stopped years earlier.” said Dr, Preisser. “This is always a hard situation because some of the more aggressive treatments that we would typically look to for treatment of an advanced or later stage breast cancer are harder for patients to endure as they get older.” This means patients may not be able to tolerate the treatment or the treatment may significantly deteriorate the patient’s quality of life.
“On the other hand, I have also seen women in their eighties or even nineties diagnosed with small, early stage cancers that were picked up on their screening exams before a lump was ever felt. These patients typically are able to be successfully treated with rather minor interventions and go on to have many wonderful, cancer-free years ahead of them. I absolutely see a benefit for screening to continue later in life, not just to prolong life but to ensure that we can maintain quality of life,” continued Dr. Preisser.
It is important to discuss any decision about screening mammograms with your doctor or primary healthcare clinician who can answer any questions you might have while you are trying to make your healthcare decisions. The breast imaging experts at GRACE are also a resource available to you. Recent studies have shown that screening mammography is beneficial for women in your age group and can help you preserve a good quality of life for longer. Since the surgery for early-stage breast cancers is often done as an outpatient and is minimally invasive, it is not uncommon for women in the 80+ years age group to seek surgical removal of small breast cancers, even if they are more conservative when it comes to adding other treatments like radiation or chemotherapy depending on the type of breast cancer they have.
Every person is different and has different health goals. It is also common for healthcare goals to change over time. Having a conversation with your doctor about your goals will help you decide on the best screening program for you. Remember that the most lives are saved when screening mammograms are continued yearly. As always, if you have a new finding or change in your breast tissue, it is recommend that you have the concern evaluated with diagnostic imaging, no matter your age.
